What is Mental Health? How Do We Create it?

What is Mental Health? How Do We Create it?

The Social Therapy Group
on Jan 19, 2014

As mental health practitioners and part of a national network of independent therapy and life coaching centers in New York City, Atlanta, Philadelphia, Boston and San Francisco, we are inviting you to join an international conversation on mental health. As community therapists and coaches we are concerned about the impact of living in a world that is in crisis. In order to help people create the conditions for their well-being, we are organizing a dialogue with progressive therapists and their clients to create a conversation that will explore how we understand and respond to the mental health needs of our communities in such uncertain times. What is mental health? How do we create it within our communities? We look forward to hearing from people with a wide range of viewpoints and experience as practitioners, patients and people from all walks of life. Please join the conversation and pass this invitation on to others you know who may be interested.

Conversation Starter

Hello, everyone, and welcome to this online conversation on mental health. I'm Hugh Polk, a psychiatrist and social therapist at the Social Therapy Group in NYC. My STG colleagues – Christine La Cerva (NYC), Jenn Bullock (Philadelphia) and Murray Dabby (Atlanta) – and I will take turns hosting the conversation, with me kicking off the first week.

A word or two by way of introduction: I'm a traditionally trained psychiatrist. Early on in my career – this was back in the ’70s – I experienced the limitations of psychiatry in helping people who were in emotional pain and started looking for what else was out there. A friend introduced me to the late Fred Newman, a philosopher who had begun practicing a new, non-diagnostic, group-based, development-focused therapeutic approach that grew out of the radical cultural perspective of the ’60s. Along with Christine, Jenn, Murray and our colleagues and clients throughout the U.S. and abroad, I have been learning/practicing/teaching this approach, called “social therapy,” for the past 30+ years. We’re among the growing number of practitioners who are creating/practicing highly effective approaches that are focused on health and growth rather than illness and symptom control. 

But enough about me! I’m eager to hear from you – practitioners, therapy clients and others who want to share their concerns about the state of mental health. We may find the conversation awkward at first, in part because it’s not often that people who “do” therapy and people who are “in” it get to talk to one another about this or anything else outside of office hours. In some circles, as you know, doing so is actually a no-no. But I think we have a lot to talk to each other about.

To start with, I’d like to know what in particular you’re concerned about regarding mental health. The avalanche of drugs being prescribed for ADHD? The seemingly contradictory fact that so many youngsters, as well as adults, aren’t getting quality help with their emotional problems and pain? The indiscriminate labeling of people as mentally ill and/or cognitively impaired? The rampant bullying among children and teens? Psychiatrists controlling the diagnostic process? What else?

And what about the unspoken (and often unexamined) assumptions of Psychology? What do we mean by the terms “mental health” and “mental illness”? Is the medical model the best way to understand and treat emotional pain? Is diagnosis a necessary or helpful component of helping people?

Along with your concerns, tell us what’s working. What are you discovering about how to live an emotionally healthy life?

I’m eager to hear what you’re thinking about…let’s talk!

Looking forward, Hugh Polk

Moderators (1)

What do you think?

Anonymous
on 2017-04-28T12:05:27+00:00
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Recent Activity

jennifer bullock
on Mar 04, 2014
"Thank you Murray.  and I look forward to continuing the dialogue in these other forums with..."
Murray Dabby
on Mar 03, 2014
"I noticed that some of the links did not work so I am submitting them again.  Thank You ..."
Murray Dabby
on Mar 03, 2014
"I would like to thank everyone for participating in this important dialogue. We have now come to..."
Murray Dabby
on Mar 03, 2014
"Thanks Cecelia, for all your thoughtful words. I completely agree about the confusion of..."
Cecilia Alcocer
on Mar 03, 2014
"Thanks for the opportunity to share some ideas and advocate for myself and my peers. My main..."
Baylah Wolfe
on Feb 28, 2014
"  Jenn, I am grappling with how to respond to your question about the relationship between the..."
Noel T
on Feb 28, 2014
"Hi Elizabeth, Hugh and Jennifer Personally I had found being labeled and categorised as bipolar..."
Baylah Wolfe
on Feb 27, 2014
"Leah, I love your post about rejecting the ‘against-ness’ in the anti-labeling movement.  When..."
Leah  Schneider
on Feb 25, 2014
"Thank you for the sharing the blog piece on your group Hugh - what an excellent example of..."
Leah  Schneider
on Feb 25, 2014
"Hi Murray -  I appreciate your thoughtful reply and the opportunity to look at my approach to..."
Hugh Polk
on Feb 25, 2014
"Leah, I think your pointing to the need for us as creators of new emotional ways of being to..."
Murray Dabby
on Feb 25, 2014
"Yes Leah. What you are saying makes sense...certainly to me. I like your example using the..."
jennifer bullock
on Feb 25, 2014
"This is such an important converstation.  As a long time advocate for youth in the state/foster..."
Leah  Schneider
on Feb 25, 2014
"It seems to me that historically, the field of mental health has taken a medical approach to..."
Murray Dabby
on Feb 25, 2014
"Yup Lauren.  You are speaking to the ongoing contradictions of the healthcare and mental health..."
Hugh Polk
on Feb 24, 2014
"  Dear Elizabeth and Noel, Thank you for honest comments.  I’m a psychiatrist practicing a..."
Elizabeth Bautista
on Feb 24, 2014
"For those struggling with a mental illness, it's bad enough for them to deal with normal everyday..."
Lauren Feiner
on Feb 24, 2014
"While I think mental health should be about healthcare, I don't think it really can be dealt with..."
Murray Dabby
on Feb 24, 2014
"Yes Yuki. While Western medicine has made huge contributions, there is also so much more. Just..."
Yuki Nakamura
on Feb 24, 2014
"No one doubts the contributions of science and medicine to the people and society. Yet, there is..."
jennifer bullock
on Feb 24, 2014
"Thanks for sharing your story Noel.  I too see such a value in  being in tune with how we are..."
Noel T
on Feb 24, 2014
"I am bipolar and have recently been labeled schizo affective. To me that's all they are; just..."
Aaron Feinstein
on Feb 23, 2014
"not to say that disabilities aren't stigmatized as well....but many are accomodated for, and it's..."
Aaron Feinstein
on Feb 23, 2014
"I perosnally would like to see a disability/accomodations based system over a mental "illness"..."
Marian  Rich
on Feb 23, 2014
"I love that you turn to writing, Diana.  It is a very healing activity and I agree that it is..."
Marian  Rich
on Feb 23, 2014
"Thanks so much for your heartfelt responses Jennifer, Murray and Randy.  How fortunate we are to..."
Randy Wilson
on Feb 23, 2014
"living socially embracing our humanity and loving you"
Murray Dabby
on Feb 21, 2014
"Hello everyone.  While it has been quiet for a few days, there has been some interesting and..."
Murray Dabby
on Feb 21, 2014
"  Thank you Marion. Such a touching moment for you to share about the experience in your family..."
Murray Dabby
on Feb 21, 2014
"  Thanks for your thoughts here, Diana. I thought you so poetically wrote about what works for..."
Murray Dabby
From the Moderator: Murray Dabby
on Mar 03, 2014 - 5:29 pm

I would like to thank everyone for participating in this important dialogue. We have now come to the end of the exploration. We (Christine, Hugh, Jennifer and myself) were excited and privileged to participate in this important conversation. We wanted to create an opportunity for people from all backgrounds who are concerned about mental health to have an opportunity to talk and learn from each other, and create something. We covered the gamut, from very personal ways in which we struggle with the mental health system as it exists and what we do about it, to conversations about the conflicts of labeling and diagnosis in the mental health process, to the social, cultural and political context of creating mental health that make it challenging and critical to engage.  You gave us a wealth of compelling ideas in these dialogues as to how we can create mental health. Congratulations to us all!

We will be continuing this dialogue in a number of different forums.  First, Jenn Bullock leads a vibrant social therapy center in Philadelphia; Christine LaCerva heads up the social therapy center in New York and I lead the Atlanta Social Therapy Center.  Please contact us at those centers to join a social therapy group or to participate in the many workshops, forums, conversations with practitioners and other activities that we create as part of the community-building, relational therapeutic activity we’re engaged in.  Also, read Jenn’s blog at www.letsdevelopphilly.com/Blog/30/.  Please also read Christine’s blog at communitytherapist.com and my blog at www.atlantasocialtherapy.com. 

Hugh Polk will be writing an article in the next few weeks summarizing and quoting from this online conversation and posting it on DxSummit.org, a website where progressive professionals share their work in developing creative new non-diagnostic approaches for mental health.

Finally, please check out Lois Holzman’s website loisholzman.org.

Lois is the Director of the East Side Institute for Group and Short Term Psychotherapy and a brilliant thinker and creator of a new developmental psychology. She is writing a very powerful book, the Overweight Brain, on social therapeutic methodology and is encouraging people to offer input on her blog that she is using to develop the book. Please contribute.

Again thanks so much for being part of this! On behalf of Christine, Hugh, Jennifer and myself, we appreciate getting to know you all! 

 

Responses(2)

Murray Dabby
on Mar 03, 2014

I noticed that some of the links did not work so I am submitting them again.  Thank You

http://www.DXsummit.org

 

www.Loisholzman.org

 

http://thecommunitytherapist.com

 
jennifer bullock
on Mar 04, 2014

Thank you Murray.  and I look forward to continuing the dialogue in these other forums with everyone.

 
Expand This Thread
Cecilia Alcocer
on Mar 03, 2014 - 4:38 am

Thanks for the opportunity to share some ideas and advocate for myself and my peers.

My main concern with this topic is the terminology and the implications of it.

Some use Mental Health while others use Mental Illness.

The medical model and goverment institutions name it Mental Health "Departments" but they focus on mental illness, they label the patient and push medication as the "solution" to the "problem".

Organizations that promote peer support and provide support to family and friends; and are pro-recovery, talk about manage the condition, etc. have the name of National Alliance for the Mentally Ill. They are focused in health and wellbeing but present themselves as the association for illness.

This are just two simple examples of how confused we are and how much we confuse the public and those who are looking for help.

Language matters and until we do a reengineering in the language we use I don't think we can go anywhere.

When someone experiences emotional distress or have behavioral problems is refered to a professional in the mental health field and what he/she gets is a label of illness that has a terrible stigma attached to it. After that the person becomes part of a different category of beings, if you are a good listener you might have heard more than one person say this and if you haven't or you forgot  just ask again.

Of course, that person can always reach out for support, which I find extraordinarily helpful, but guess what, this wonderful support could in the form of a membership at the National Alliance for the Mentally Ill. Honestly, I wouldn't like to carry that membership in my wallet, I wouldn't be proud to belong there, I wouldn't tell anyone, would you?

Consequences of using that LANGUAGE:

- People are not seeking help

- People are not getting help

- Those who are seeking/getting help are not getting quality help

 

In my experience both as a consumer and as a peer professional I can say:

- There is no one model that fits everyone, there is no one theory or approach that works for all. But the medical model is definately failing us, it needs to be fix in every way.

- Professionals that deal with human beings need a deeper understanding of the complexity, connection and all the dimensions of the person. We are one but we have body, mind, emotions; and even for those who have difficulty accepting it we have soul/spirit -or let's find an ecumenical name for it- but it's something totally misterious and intangible that plays a great role in the persona and personality of all of us, it's undeniable.

- Persons who have to deal with mental and emotional challenges need a comprehensive, compassionate CARE.

- Please, no person who seeks professional help likes to be consider a CLIENT = $$$

 

What I would like to promote is new way to communicate about this topic applying some reengineering in the language. As a consequence of this I expect a shift in the professional and the consumer view as well as the public in general.

Forget about mental health or mental illness instead of that let's say:

Personal Wellness. 

A person with a medical/emotional condition.

Someone who is experiencing mental/emotional challenges.

Someone who needs support.

Patient with symptoms that need medical attention.

The symptoms that this person experiences require such and such medication.

Patient who has such and such symptoms and might benefit from therapy. 

It has to be about finding a positive, hopeful different way to see how chemical, genetic, environmental, sociological factors affects us and our behaviors. And bring together more and better ways to deal with them.

What is working? Good news, there are many options that work for different people.

Alternative medicine: homeopathy, accupuncture, supplements.

Breathing techniques.

Movement in all posibilities: walk, jog, exercise machines, sports.

Mind-body practices: yoga, ba-duan-jin, qui-gong, etc.

Reiki.

Art in all the possibilities.

Socialization: human contact, friends and support groups.

Spirituality: prayer, meditation, organized religion or just personal relationship with a higher power.

Healthy life: free of addictions, balanced diet, sleep higiene.

Self-care and self-knoledge.

Self-education/Research.

Perseverance, persistance, resilence.

LOVE

 

 

 

 

Responses(1)

Murray Dabby
on Mar 03, 2014

Thanks Cecelia, for all your thoughtful words. I completely agree about the confusion of language, particularly when it comes to mental health.  And I find that so true in so many areas of our culture. The 'mental health' establishment has do so much to focus on deficits, disorders and diagnosis. To me the focus need to be on possiblity, process, play, performance...what we can do as a people to grow, to develop.

I like all the options you have put forth...and i am sure we could collective develop many more that focus on our growth, rather than thinking we need to 'fix' what is wrong with us.

I am going to putting closing words to this over all conversation and glad you joined in.  I will be putting links up where this and other related conversations can be continued. Hope you can join us!  

 
Expand This Thread
Leah  Schneider
on Feb 25, 2014 - 11:20 am

It seems to me that historically, the field of mental health has taken a medical approach to understanding such abstract and complicated phenomena as our mental processes. Of course this approach does not work because we cannot trace pathogens (as we can in medicine) to the cause of mental illness. 

One similar example in how the medical field tries to tackle something so complex and dynamic is the "obesity epidemic." There is no pathogen for obesity (although there is a genetic component to being overweight - which is a different issue than the obesity epidemic) yet medicine tries to address it with a medical model, but often fails to look at the socio-cultural aspects of the "disease." 

I hope this is making sense, but for me, it's like we are approaching mental health as the medical field approaches something as complex as obesity.

 

To me, creating mental health seems to be about working within the system that we have and making changes from within, little by little. I think things are already going that way. Humans want to understand such seemingly intense and scary things as "mental illness" so it makes sense that as humans, we try to label and create categories. I think understanding this human side of the way we try to make sense of things may allow us as "creators" to "start where the people are at" and work from there. 

 

Responses(5)

Murray Dabby
on Feb 25, 2014

Yes Leah. What you are saying makes sense...certainly to me. I like your example using the obesity epidemic. I agree...how could one seriously treat such a epidemic from a medical frame? It is such a challenge just to work at living healthfully, given the social frame many of us live with. It is such a profoundly cultural phenomenon influenced by so many factors.  

I appreciate what you said about working to make incremental changes within the existing framework.  However I wonder if the existing framework is limiting the kinds of questions and ways of looking at the problem, and that may always be. Kind of like reforming the education system, when schools are maintaining the framework of teaching young people as individual learners, when a strong case can be made that support the whole group to learn would be more effective.

I was wondering what you thought about continuing to work within the framework that we have to improvement, while we simultaneously build outside of that, to create new frameworks that create success and brand new ways of looking at the problem?  I think there are many examples of that going on, - for example looking at mental health as having to do with creating new culture rather than new medical approaches - that is influencing the very conversations we are all trying to have. What are your thoughts about that?

Thanks so much for your thoughts and the work you do!

 
Hugh Polk
on Feb 25, 2014

Leah,

I think your pointing to the need for us as creators of new emotional ways of being to “start where the people are at and work from there” is very important and necessary.  As a social therapist leading groups every week, I try to help group members do that.  I recently led a group where people were having a hard time accepting what someone was saying, how hard her life is—they (understandably) wanted her to just get better.  I asked them why they were having a hard time accepting her and people spoke about how painful it is to accept our pain, hardships, difficulties.  They thought it was the same as being passive.  I said I thought it was critically important to radically accept where we’re at in order to begin to be able to create something new.  Our pain, difficulty, failures, humiliation—this is (among other things) what we have to build with.  I asked if they would work with me to engage our pain.  They said yes.  I was touched.  I wrote about this in more depth on Christine LaCerva’s blog—she's the Director of the Social Therapy Group.  The blog is at http://thecommunitytherapist.com.  The piece was written on Feb 19, 2013.  It’s an abbreviated transcript of this group session called “Radical Acceptance.”  I’d love to hear yours and others’ comments.  Thanks for your thoughts.

 
Leah  Schneider
on Feb 25, 2014

Hi Murray - 

I appreciate your thoughtful reply and the opportunity to look at my approach to therapy from different angles. 

At this point in my life and career, I have found that it is most useful to deal with the reality that exists and find ways to transfrom it from within. I agree, the direction the field of mental health has taken has been damaging to people, yet, it has provided some foundation from which to work. Many of the traditional ideas of psychotherapy and psychoanalysis have been refuted, especially in the field of social work. I was drawn to how social workers are encouraged to look at the various layers and interactions of the individual/family/environment, etc. and how self-disclosure can be helpful to clients. Furhtermore, i was drawn to how social workers are encouraged to look within ourselves, and to consider how we may be encouraging or derailing change. 

I believe change starts with ourselves. I believe I do the best work by helping my clients create change within themselves without denying them the reality they are in. Some therapists may always use labels, that's not a good thing, but by being against labels I think we give them too much power. I say, don't use the label, your effectiveness will show, and people will want to know more about it. 

 
Leah  Schneider
on Feb 25, 2014

Thank you for the sharing the blog piece on your group Hugh - what an excellent example of "starting where we are at." 

I also really liked your approach, that you helped the group members see and understand that they were avoiding the dismal reality of their situations and that this was preventing them from doing the work. 

Thank you again for sharing! It's always nice to see examples. 

 
Baylah Wolfe
on Feb 27, 2014

Leah, I love your post about rejecting the ‘against-ness’ in the anti-labeling movement.  When your radically accept your client, when you create growthful conversations with clients without putting them in a box, the person may sees new possibilities for their lives; they may be curious and like you said “they will want to know more”. That’s collaboration in the creating of your therapeutic relationship.

 

 

 

 

 

 

 

 
Expand This Thread
Lauren Feiner
on Feb 24, 2014 - 1:01 pm

While I think mental health should be about healthcare, I don't think it really can be dealt with in the usual healthcare manner given how healthcare is currently organzed.   Current healthcare is about treatment and (hopefully) cure.  Mental health, when related to in the same way, just becomes failure.  Most mental health issues are continuous battles...while some involve typical healthcare routines such as medication, most are not fully treated/curable, and can't achieve a clear ending to the condition.  And because of this, there is often no measurement for the success of the treatment/cure.  Many people cannot afford such an open ended financial commitment to mental health, and insurance companies rarely agree to pay for such a commitment.   Also, if someone can be treated with meds, insurance companies might wonder why they should reimburse for therapy.  Why is therapy needed if the meds work?  And it the meds don't work well enough that the person still needs/wants therapy, why pay for the meds in addition to therapy?

 

Responses(1)

Murray Dabby
on Feb 25, 2014

Yup Lauren.  You are speaking to the ongoing contradictions of the healthcare and mental health system. I liked your statement that most mental health issues are ongoing struggles. Unlike the medical model which requires the notion of the presence or absence of illness, symptoms, behavior, etc., doesn't it seem that an approach to creating mental health need to be about how we live and create our lives? 

 
Expand This Thread
Yuki Nakamura
on Feb 24, 2014 - 11:45 am

No one doubts the contributions of science and medicine to the people and society. Yet, there is a difference between something that can be bad and something that can be dangerous. The categorizations that science and medicine does about what is and who is mentally ill, can be dangerous depending on the way it is used and applied. It may make people think that they have "problems". It can make people around them to think that as well. It is in these cases that each and everyone of us has to think of a way to escape these processes.

 

Responses(1)

Murray Dabby
on Feb 24, 2014

Yes Yuki. While Western medicine has made huge contributions, there is also so much more. Just the advent and understanding of non-western practices have demonstrated to me how much western practice is so shaped by a dualistic method that limit looking at the entire life practice of human beings in taking care of health.

I do agree with what sounds like a concern about the danger of this kind of practice when it comes to defining who we are as human beings, via mental illness diagnosis.. Afterall, as simple as a label can seem, that is what is happening...defining or redefining us as human beings. This label saddles us and our culture with a new understanding of human as reduced to certain traits, personailities, abilities and deficits.  Not only that, we had no part in the decision or creating of the label! Now what if we did, that we had a say in the kind and character of the label that we are comfortable or happy with, or what might be useful to us? Is it possible to create our mental health as well as the conditions for when labels can be useful and what they even can be.

 
Expand This Thread
Noel T
on Feb 24, 2014 - 7:33 am

I am bipolar and have recently been labeled schizo affective. To me that's all they are; just labels that put me in a box for others to pass quick biased judgement on what they have heard or read of others with the same diagnosis. I am sure you all have quickly received a quick flash of this biased judgement with reading the two words, bipolar and schizo affective.

Tho true statements about my diagnosis, I have fought extremely hard to battle against the symptoms of both diagnosis to stay well. It's been a long battle with a lot of learning curves. So being released out the other end so many times a lot more stronger than before, I believe I have refined a sense of true wellbeing that can be well sustained and maintained. Each battle with each past episode has taught me a lot about who I am as a person, and what I need to do to stay well and healthy.

For me, mental health is knowing how I am feeling at any given moment of every day. It is about knowing how long I have before deteriorating, knowing how to instantly fix this deterioration that leads towards a relapse, and what my necessary steps are to remain proactive to maintain wellbeing. I have heightened my internal sensitivities to now knowing how long I have before a relapse. I know of instant quick fixes, and ways of being that sustain and maintain wellness. I even know my internal bodily processes and feelings towards depression and mania. 

Unfortunately for newly diagnosed patients of bipolar and schizo affective; these questions are a marathon away before they become tangible. 

Unfortunately, there really are not many individuals that can successfully guide those affected by bipolar across the planes of normal functioning to depressed or depressed to normal, normal to mania and mania to normal.

Unfortunately, those suffering the illness have to go through the full blown range of sufferings be it the medicated suffering or the suffering of the illness itself while on medication or off medication. The only cushioning they have to soften the impact of the struggle with the illness is medication, experience and self learnt insight or advice from others who are willing to give them a hand.

I believe that by having a person that can project insight at the right moment and at the right time will become highly useful for individuals suffering bipolar and schizo affective illnesses. Medication for a quick fix, has its time, purpose and place, but for complex matters of the mind that is always in constant change, medication will never be the true remedy that will truly heal as I believe a conscious effort needs to be realised when trying to heal complex illnesses of the mind therefore by keeping conscious over the regular and irregular fluctuations of the mood, feelings, sensations and emotions gives a rudder and a true gauge of a real conscious effort towards recovery and true sustainability of mental health and wellbeing for an individual. 

 

Responses(5)

jennifer bullock
on Feb 24, 2014

Thanks for sharing your story Noel.  I too see such a value in  being in tune with how we are doing 'internally' to practice well being.    What do you, and others, think about the importance of being 'in tune' as well with what is going on in the world around us, in our relationships, how we are doing with connecting versus isolation?  I think it is equally valuable to our wellness to question the  western dualism / separation of  internal-external worlds.  Both effect and relate to one another. 

 
Elizabeth Bautista
on Feb 24, 2014

For those struggling with a mental illness, it's bad enough for them to deal with normal everyday living. I believe the worse part of "normal everyday living" is having to deal with people who judge you, think your illness is just "something in your head", something you just "have to deal with" or worse, force you to fit into a pattern of behaviors. If someone says, "I'm dealing with a mental illness", that itself seems less important than "I'm dealing with cancer", "I'm dealing with diabetes" or "I'm dealing with high cholesterol." As a society, we seem to forgive or sympathize those who have cancer but we don't seem to do the same for someone with a mental illness. Why do you think that's the case? In the work place, we worry about the health of someone with a heart problem ie someone who just had bypass surgery, we are provided training on how to deal with someone who has a blood sugar issue, we are even encouraged to get CPR training and first aid but we don't know how to deal with someone at work with a mental issue. We don't even consider that what we do or don't do to force them into a specific set of behaviors - come to work on time, continue to provide excellent service, in essense be a normal person - may be taking its toll on their health.

Just because mental health isn't something we can quantify, why is it treated less of an illness than all other physical illnesses?

 
Hugh Polk
on Feb 24, 2014

 

Dear Elizabeth and Noel,

Thank you for honest comments.  I’m a psychiatrist practicing a non-diagnostic group therapy called social therapy.  We work hard in our groups to explore and challenge how we are all socialized in our culture to label things, including people.   I work with a man who calls himself depressed and has always believed that he has “Major Depressive Illness.”   I asked him how he knows he has that illness?  How did he learn to talk that way about himself?”  The group has joined me in exploring how he was told this story early in his life—in his family, in school, etc.  The group says to him, “We don’t see you that way—we experience you here as being very open, courageous in sharing how you think, very giving to other people in pushing them to not label themselves.  You stay away from us when you insist that you’re mentally ill.  Yes, you have problems as we all do—but stop labeling yourself.  How come it’s so hard for you to hear what we’re saying?”  We’ve discovered that he and all of us come to believe those psychiatric labels and stories.  They have the weight of science behind them, even if that science is deeply flawed.   Join us in changing this culture of labeling—and you are by participating in this conversation.  It’s great to meet you both.

 

 
jennifer bullock
on Feb 25, 2014

This is such an important converstation.  As a long time advocate for youth in the state/foster care system who have been traumatized, I empathize with the position that mental ilness should not be seen as a less important / less legitimate /  step child to other medical illnesses,  and that seeing mental health struggles as an illness  has been one way to humanize and fight for the rights of the 'mentall ill'.  However, as a social therapist   I have seen  how labels can  ironically serve to separate us and keep us from creating kinder, more caring ways of relating to one another.  Hugh's example of relating without our societal labels is so helpful.  What if we can  go even further in humanizing our treatment and views of one another's struggles,  pain, difficulties?  What if the medical model with it's diagnoses of mental health struggles has reached the limits and in fact holds us back from seeing 'mentally ill' people as full participating human beings in the community of life.

 
Noel T
on Feb 28, 2014

Hi Elizabeth, Hugh and Jennifer

Personally I had found being labeled and categorised as bipolar made me think that was final. Just like being diagnosed with terminal cancer with no full recovery. No way out of it. Having no way out of the diagnosis almost sets the thinking that the diagnosis is all you will be. I felt I needed to fight against what I was diagnosed with. I believe if I didn't fight against the diagnosis of bipolar, I wouldn't know better. I wouldn't know that yes, there is consciousness and awareness in every action and thought. And that 99% of the time, mental health or the road towards mental health lies in the awareness of internal and external processes and their affects on you as a person. Most times medication over rides this awareness that is so crucial to the knowings of the beginnings of a relapse. For me, it is this consciousness and awareness that is needed for knowing and being able to effectively constantly monitor my ups and downs. 

I guess the question now is, what can be done if not already done, to best teach a bipolar how to read their bodily cues and sensations that are instant messengers of where they are at on their bipolar scale, high and low. Do they need experience in knowing the contrast between mental health and mental illness? (I know that's how I learnt) or is their a way this can be done more efficiently? Now that I know a better and healthier way; for me, being labeled as bipolar and schizo affective really is nothing. It doesn't bother me as much as it used to because I have a back log of failures and triumphs that have moulded me.Tho I wouldn't want to wish it on no body; is this part and parcel of the way to recovery, or is there a way of fast tracking to a quick long lasting effective solution?

 

 
Expand This Thread
Aaron Feinstein
on Feb 23, 2014 - 3:22 pm

I perosnally would like to see a disability/accomodations based system over a mental "illness" system for the "invisible" disabilities (i.e. autism, PTSD, TBI...). Autism for example is lumped into the DSM, but has physiological/medical, social, and sensory components-any of which could be more dominant for the individual. This would allow for people who have greater needs to recieve the accomodations and receive the reimbursements that are necessary for them to flourish in any culture. It would also allow a social environment where people could learn about accomodations for disabilities of differences rather than the stigma of  mental "illness".

 

Responses(1)

Aaron Feinstein
on Feb 23, 2014

not to say that disabilities aren't stigmatized as well....but many are accomodated for, and it's refreshing to go to places that make these accomodations.

 

 
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Murray Dabby
From the Moderator: Murray Dabby
on Feb 21, 2014 - 8:25 pm

Hello everyone.  While it has been quiet for a few days, there has been some interesting and touching conversation in the last 24 hours.  I would love for you to share your thoughts to any and all of it.

 

 
Marian  Rich
on Feb 21, 2014 - 10:07 am

There is so much to say about this topic I don't know where to begin... so I will begin somewhere close to the upset I feel about the topic of "mental health" in  a sick culture such as ours, within a world filled with chaos and uncertainty, poverty and inequality, the subjegation of women, racism, and homophobia.  

Right now this question of what is mental health/illness is very present in my life/in my family.  It seems to me that people go so quickly to self-diagnosis and labeling of emotions (i.e., "I'm depressed" or "I'm fucked up"), rather than creating our lives with all of the pain, joy and worry (I'm a worrier) that comes with living.

My father is in the beginning stages of Alzheimer's. It has given me a chance to practice social therapeutics in a way I had not before and thereby I have, once again, experienced the power of this practice of method.  By encouraging my father to open up and talk about his fears and to play with all of what he is experiencing is a way that we can find/create joy in the midst of his "illness".  When he told me he has no fun anymore, we immediately created fun by improvising together (I taught him the one word story game).  Performing is always something we can do with our pain (rather than being our pain).  

When Philip Seymour Hoffman died of an overdose I thought so much about emotional pain and the impact it has on us within a culture that says, "If you 'make it' you'll feel better."  It's all so twisted.  The poor suffer from poverty and the rich suffer from extreme alientation. I found it upsetting when people related to Hoffman as other than a man in deep emotional pain.  The role of blame is huge in fostering this culture of deprivation and alientation - someone has to be at fault.  So many people turn to drugs or alchohol or food or whatever to aleviate their pain.  We can use our emotional pain to create environments to heal each other.  I see this every week in social therapy.  

Radical acceptance is another tool I carry in my toolkit.  As a person who leans towards self-involvement (don't we all to some extent in our culture?) and neurosis, I have learned/discovered that I can use my sense of humor to find the funny in my own craziness.  To embrace that my emotionality is a strength and a weakness, it is not a problem.  Allowing problems to vanish (thank you Ludwig Wittgenstein) is a huge discovery for living a healtier emotional life.  

Living socially, embracing our humanity, being philosophical, allowing for life's irony and paradoxes, laughing a lot, loving a lot, giving even when it seems impossible - these are all things I've learned about mental health.

Lastly, thank you for creating this conversation!

 

Responses(4)

jennifer bullock
on Feb 21, 2014

Thank you Marian for all that you give.  Very moving what you share here. Creating with all of our emotions  - performing our pain not being our pain, so powerful.  It reminds me of a conversation I had this week with an african american middle aged woman struggling with chronic unemployment and poverty after previously being middle class most of her life, and she is not  having fun either.  She is stuck in the role of getting (fixed, unbroken, a job, etc) which is what we are taught to do  - be self-focused getters,  especially in the face of desperation, fear, pain, humiliation.  I am in the process of inviting her to take another strategy with me  towards her life, to join  one of our social therapy groups in Philly,  to learn to build community with others, to be a giver, to perform,  as you say,  her pain versus be it.  I hope she says yes to the offer. Thanks agian for  your comments.

 
Murray Dabby
on Feb 21, 2014

 

Thank you Marion. Such a touching moment for you to share about the experience in your family nowadays.  I have found that relating to people with Alzheimer's, - or any situation where our cognitive abilities are not considered normative,  where there are speech problems or our ability to know is limited - is very challenging. It can slam us into the wall of deeply held beliefs that we need to know what to do, or what is going on, or that there is something we can understand.  I had been reading Lois Holzman's blog on the Overweight Brain recently (she is writing a book that we all contribute to on her blog site loisholzman.net . I SO recommend it. She talks so eloquently about how we are increasingly limited in trying to rely on knowing, in believing we have to have answers in these very challenging situations like the one with your family.  And that experience can produce incredible pain. On the other hand, I was feeling such a sense of joy, that in those hard moments of transition and confusion with your dad, that you can use your creativity together to build something that brings you closer. (I had a similar experience with an man diagnosed with moderate retardation yesterday and we created with TV shows and the possibility of creating new characters and TV show themes..It was joyful and we left each other with much warmth).  Thank you.

 
Randy Wilson
on Feb 23, 2014

living socially

embracing our humanity

and loving you

 
Marian  Rich
on Feb 23, 2014

Thanks so much for your heartfelt responses Jennifer, Murray and Randy.  How fortunate we are to have and to build this loving community... now THAT'S mental health! 

 

 
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Diana Bee Dash Bee
on Feb 21, 2014 - 2:24 am

For me, mental health means having a relationship with the contents of one's head that facilitates, rather than hampers: growth, development, the potential for joy, the ability to deal with sorrow and pain, and the ability to not be a jerk to other sentient beings. It is a state that, when inhabited, makes people better at doing their lives mindfully and with less suffering. 

 

I spend a lot of time thinking about the disproportionate vulnerability of people who experience financial hardship, or even those who are not in crisis financially but also not wealthy. Insurance providers inattention to the huge impact mental health has on overall health and functioning means they reimburse at laughably low rates and, even in a post-ACA landscape, state and federal services provide paltry replacement coverage at best. To the extent that services are covered at all, the services covered tend to be available only *after* people are no longer coping in basic ways - the strategy of public/state mental health care is wait for something to break, treat it intensively and through heavy reliance on pharmaceuticals, and then go back to doing nothing and not following up. 

 

I think there needs to be a great deal more policy and funding support for mental health care across the spectrum, and that the definition of mental health care needs to change from a triage model where we wait for things to break rather than trying to prevent them from breaking in the first place. And I think we need MUCH more evidence-based practice regarding methods, drugs, and treatments that work - what are we finding out about how people experience and participate in life after seeking and following a certain course of care? 

 

Things that do not work have included traditional psychotherapy, medications, and talking too much about stuff I already know is causing suffering (see: traditional psychotherapy). Things that work for me have included not trying to shape myself for others' pleasure/to fit their idea of what my behavior "should" be while also trying to be kind, being aware of my impact on others, and communicating authentically with all around me. Also, with regard to anger, resentment, fear, shame, and anxiety, I feel like I need to experience some of this and it can actually be very helpful and focusing and generative in my creative/advocacy work, but too much of it is poison for me (probably for everyone), so I try to balance between honesty and “letting loose” and more deliberate efforts to recast negative emotions and create a chance for discussion and increased understanding for my fellow creatures-with-feelings. Another thing that helps is turning my desire to communicate and connect with others into informative, uniquely voiced independent journalism, fine arts writing, comedy, and media criticism (I have trouble communicating verbally sometimes so writing makes me feel more centered and like I have agency). I don't always succeed at one or another of these methods and I am okay with that, because when I do I am able to be happy, functional, and alive even in the midst of "big picture" things - painful family situations, chronic illness, loss, change - that cause suffering. So it seems worth continuing to try.  

 

I have a whole bunch I want to say about the role of positive thinking and quasi-positive thinking in mental health and health in general, but for now want to stop here. 

 

Responses(3)

jennifer bullock
on Feb 21, 2014

I appreciate your comments here Diana your passion comes through!  Can you say more about why you think we need more evidence-based therapeutic practices?

 
Murray Dabby
on Feb 21, 2014

 

Thanks for your thoughts here, Diana. I thought you so poetically wrote about what works for you and what is important to consider.  Your passion about this issue shines through.  I also thought about Jenn's question to you which was interesting and provocative to me.  One thought I had is how you shared what you said so powerfully, and I felt your experience in that. How human and humane that is…. And then on the other hand, how evidence based research does so little, actually I would say nothing at all, to capture that humanness, our capacity to contemplate, and our capacity to create. There is no room for that in the science of seeking evidence. However our collective expression and activity of changing, developing, transforming speak volumes.  There is new research out there that is suggesting and new kind of research…"Practice Based evidence"  While it still falls short, I think it goes more in the direction of creating our mental health together, by 'not being jerks to each other' (i loved that)…and creating environments with each other, learn from each other and for all to give what we are able.

 
Marian  Rich
on Feb 23, 2014

I love that you turn to writing, Diana.  It is a very healing activity and I agree that it is very centering.  I'd like to hear what you're thinking about positive thinking!  I struggle with the constant evaluatory voice in my head that causes way more negative thinking than I'd like.  I'm sure I'm not alone with this struggle!

 
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Kim Walker-Daniels
on Feb 18, 2014 - 5:36 pm

This is a topic that fascinates me. Under a medicalized model of healthcare, a person is either sick or well, ravaged by disease or cured. The same holds true of the mental health industry, and the insistence by many (including payors) that the medical model applies here as well. There is a continuum of states between illness and wellness. The mental health recovery model should be one in which we, especially as PMHNPs, assist each person to maximal function and quality of life no matter where they are on that continuum. Each person should be able to define for themselves what mental wellness means for them.

 

Responses(1)

jennifer bullock
on Feb 19, 2014

Kim I appreciate this phrase  'there is a continuum of states between illness and wellness'.  Your point that the sick-healthy dualism in both the medical and mental health worlds are an unhelpful and inaccurate oversimplification of our actual multilayered messy actual life-as lived. 

What does PMHNP stand for? What does this appreciation of the 'continuum of mental wellness' as you say look like in your work?

Your comment makes me think of a very moving and difficult conversation recently in one of my social therapy groups where I was inviting group members to  see themselves, their relationships they have co-created with others, their choices, their 'mistakes' as more complicated than the good-bad,  right-wrong dualistic lenses  our culture programs us to wear.  We were working together on very painful situations where partnerships were in crisis, on the verge of breakup or changing significantly in some undesired way. Group members were  taking sides on issues and quickly wanting to get to resolutions, problem solving directives. When I asked the group to slow down and check in with how we were doing together, one client shared in a very moving way that her relationship with her long-time partner  is very complicated and full of many elements, including  unspeakable abuse as well as  tremendous love and support.   In our either/or, sick/well  framework,  we can't  have both and see the whole picture, perhaps because it is way too painful at times to  embrace the full picture of our lives and relationships.  Groups creating new, more layered ways of seeing can create the support needed to  have the pain and messiness of our lives. What do you think?

 
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Murray Dabby
on Feb 17, 2014 - 1:47 pm

Hello to our wonderful online conversation!

This is Murray Dabby, and in our rotating moderation, I will be with you as moderator for the next week.  I so appreciate the conversation in the last three weeks and the very powerful and serious statements that people have shared.  And it is great to see people I know and people I now have the opportunity to know. I hope we will continue.

A little about me: I am a long-time social therapist and community builder, based in Atlanta. I so appreciate the powerful conversations about the impact of diagnosis, as well as the conditions that we live with.  These conditions makes creating mental health together so needed and at the same time, so very challenging. Many years ago, I was involved in the research work (as a newly therapist) in the developing DSM-III.  This was in the late 70's when, diagnosing, which many already considered to be problematic in its form, was taking a turn to be more popularized, out of control, and leading to an epidemic. The manual started to set the stage for the growing diagnosis of all kinds of life circumstances, social problems, ways of living so that they can be medicalized. This experience along with other personal ones brought me to wanting to do something about how we engage in the creating of human growth and a new way to do something about creating mental health. As we have shared, there is serious psychological, social and emotional distress in the world, and the challenge is always how to relate to that in a way that is humane and growthful.

I was particular struck in the last weeks by so many different, very open and powerful comments by so many of us about the circumstances that we are living through. So many comments to touch on but here are a few.  Anthony, Elouise, Evangelos, Lisa and Aaron and many others talked about the conflicts, as well as the different sides of labeling and conformity including both the problems and comforts that doing so offers, Vesna, Yemayah,  John and others spoke so movingly and poetically about the  statement about how our world is organized today, and with the hope, sometimes about the utter frustration of living with our challenges. And I was struck by some of the recent comments by John about the challenges that men and women have in being together and the seeming impossibility of creating a world together around new ways of living and being.

Yet this is our world.  

I wonder if folks can share about how you create in our conflicting environments? How do you take on the task of creating our mental health.

How do you, or have you created opportunities for people who have many differences in how we live, different life experiences, whether gender, race, culture, sexual orientation, build something together? How do you / we create community?

Thanks for your continued input to this valuable conversation….

 

Murray

 
John Burns
on Feb 16, 2014 - 7:08 pm

I don't use the expression "mental illness" as I think it is a corrupt concept.  It is a metaphor from physical health area.  Someone with a high fever and red splotches is sick.  Yes.  Someone walking in circles and talking to himself may be just releasing conflict.  But if the police are called he will be taken in for 72 hours and probably told he is schizophrenic.  Notice how ugly the diagnostic terms are.  They reflect the industrial revolution.  It might be a kindness to simply say, we think you are crazy!  Well, if walking in circles, etc. is not something we do, then what else can we say?  So it is a kind of social prejudice.  Then there is behavioral disorder.  Ha.  Conformity is so much to be applauded.  As in the military. 

Extroverted, other directed Americans are so vulnerable.  So  gullible.  But that can change.  “It is really amazing what people can do. Only they don't know what they can do.” ― Milton Erickson

 
John Burns
on Feb 16, 2014 - 5:06 pm

Wihout exceptional circumstances interveniong more and more persons will be going mad in the coming decades.  The food is bad; the water and air are bad.  The educational system is broken.  And the homes are becoming frightening.  This is America which must at some point deal with its past not as fantasy but as fact.  While it is certainly true that formerly there were oases of healthy living the nation as a whole has been going in a violent direction since not long after its founding.  Wars.  Slavery.  Genocide of native Americans. More wars. Economic oppression.  Exploitations of Third World nations.  So given all those repressed factors it is no wonder that we have a fairly criminally minded government.  The "mentally ill" are simply signalling the hidden realities.

LIes and hoaxes can drive people  crazy.  And they have as we know.  I believe James Hillman caught on to this long ago.  Without some truth flowing through the country's veins the situation is hopeless.  It is almost a joke that the medical profession believes a pill could make years of falsehoods vanish and bring anything like mental health back.  And yet this is science!  Man as subtle machine needing an adjustment.  Despair (aka depression) simply a matter of chemical imbalance.  Really that is an insult to nature. 

Imagine an America with lots of good communities.  Where banking fraud is prosecuted.  Where no matter your income you are under the law just like the poor and middle class.  Where gov official including the highest can end up in jail.  Where drug problems are treated not as criminal offences which benefit the  prisons for profit.  Where war is replaced by high quality diplomacy.  For many this is taxing on the brain.  But it is not impossible.  That is what small nations have to do.  The ones that do not have gargantuan military budgets. 

And finally homes with someone almost always there for the children or to take a call from school.  Where marriage is not till it bcomes uncomfortable.  Where pornography is considered stupid which it is.  Well, a lot of illusion and delusion would have to go.  The constant bombartment that people including children endure of money and sex and things has destroyed our capacity to see  clearly. 

Those that can can start clearing their own lives: books instead  of TV or web surfing. Classics for example. High quality music.  A gardent. A dog and cat.  Learn to sit still and reflect and appreciate.  Less work and more leisure.  Etc.

Otherwise it is doom.  Political action groups are fine but not too much of a solution.  We won't ever get a good president anyway.  Dirty hands is what they are after.  The tiny revolution  in your own home is the most  powerful. 

 

 

Responses(2)

jennifer bullock
on Feb 16, 2014

Thank you for  this note John I so appreciate your last line  'A tiny revolution in your own home is the most powerful'.  I would respectfully add a 'tiny revolution everywhere by us  co - creating together new, more humane practices of life, therapay, community, healing, etc.'

 
John Burns
on Feb 16, 2014

The reason I am emphasizing home here is that first a person needs to become strong in himself or herself.  This may take years even.  The forces in the public are quite powerful and twist what we say and do in surprising ways.  So in the meantime I would recommend that a person be courteous and rather inconspicuous.  I believe Socrates recommended this.  Put your own house in order first.  Who are you?  What are your goals.  What is troubling you?  And there is nothing better than sitting quietly and reflecting on the passing moments.  As the German poet, Goethe, put in solitude talents are nutured.  Recently I read a quote from a well know actor:  I always thought being alone was the worst thing; but I found out people that make you feel alone is worse. 

 
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Lamy Avatari
on Feb 15, 2014 - 1:30 pm

Can stronger communities (with great ability to accept / embrace difference, and abundant compassion) reduce the distress of mental / emotional crises?  Can they reduce childhood adversity (which is associated with many kinds of mental distress in later years)?  While we're at it, can they reduce or eliminate poverty (a major component of childhood adversity), via co-production and a sustainable local economy? 

 

Responses(7)

John Burns
on Feb 16, 2014

I think the beginning point is the relationship between men and women. Everything builds out from there.  You can determine the "mental health" of a nation just by determining how well men and women relate. 

 
jennifer bullock
on Feb 16, 2014

Can you say more John as to how you see that we can determine the mental health of a nation by determining how well men and women relate? That is an intriguing statement.  I think it is hard for people, in and out of therapy,  to talk openly and non-defensively about  how man-women relationships are organized in our culture.  Let's try to do it here. My invitation  for all of us is to be open and curious as we proceed with this line. 

In my work with couples (straight and gay) and in my social therapy groups in Philly,   we are  often looking at how  societal issues of racism, classism, sexism, all the isms impact on how we relate to one another and how isms are a way we can stay away from one another. 

For example, women in my therapy groups can sometimes  let men 'off the hook' when the men are acting out with the women in their lives:  a male client says  'i  lied to my wife again, I know we worked before in group on me  being more decent  and loving towards my wife, but she was being mean again to me about  such and such,  so I  told her a lie about such and such and I feel bad about it'.   The women in group can sometimes be seduced into feeling sorry for the man, taking his side, making excuses for him.  On my good days I can sense that and ask the group such questions as: what's going on for group right now? , or 'if one of the women was sharing this very same thing you all would be more challenging towards her, so how come it's hard to get closer to  the male group member? or 'What does this  raise for the women?' or  'How do we think (male group member) is doing with us women in group?'  On my not so  good days I might  be  leading with my own sexism and either join in on letting the guy off the hook so I can play nice/likable  lady therapist or  I can be  unfairly hard on and lacking compassion towards the women group members by seeing them as only naive.  This by the way is how women can be anti-woman,  including me sometimes.

What do folks think?  And I am eager to hear more from you John.

 
jennifer bullock
on Feb 16, 2014

Thanks Lamy for your note.   What do you think:  how would you answer your question? 

 
John Burns
on Feb 16, 2014

I grew up in an area where many of the older women were daughters of homesteaders or even in some cases the wives.  These women had a status which apparently many women in America did not have.  As a child and young person I never got the idea of women being inferior.  I heard too many stories about women having to help their husbands balance the budget or get out of trouble.  So women had considerable respect.  At univerity at that time women still went to college mostly to find a husband.  And I began to have contact with women whose mothers apparently did not like men and were pursuing women liberation, an idea I had trouble relating to.  So this just for background.

Men are typically fearful of women's negative emotions, especially their anger.  So right at the beginning things  are skewed.  Men also typically, as I am sure you know well, are hesitant  to venture into the subconscious where all sorts of dark things hang out and threaten.  Most women instinctively know this.  And if they are mistreated or have been they take advantage of this survival mechanism.  Men coming out of his situation of a mother or sister  or girl friend begin to feel a certain anger at women.  Pretty soon these men and women can not get along.  I believe this situation is getting more and more prevalent.  On  the whole though I would incline to blame the man.  Men in America are cowards.  Look at Congress.  The academic world.  And other institutions dominated by men. 

Of course  people form couples for a variety of reasons but I am especially looking at marriages with the idea of having children.  How are these going to function in this society which seems to like to poison people?  TV and the Internet can be terrible poisons as well  as water and food and vaccinations.   In France it is rare for children to be put on psych  meds.  What is going on in the American family?  Is the man really paying any attention to the welfare of  his family--or is he completely trapped in the economic  aspect.  These families can not afford fights.  They need every second to steer a good course.  But if the  men and women are trying to recover themselves from bad home experiences, it may seem hopeless.

Ideally men should come to terms with themselves first before creating a relationship.  They need to  meet themselves and make good terms.  Otherwise the partner is asked to help pay this debt to the past--and he or she may be drowning in his or her own debt of experiences as yet uncognized.

Whew. Hope this is not too much at once.  Thanks for responding.

 
John Burns
on Feb 16, 2014

There is a fine book written by a Dutch psychologist called Original Wisdom about the native people of Malaysia as late as the 1950's.  A peoples without mental illness or crime.  It was too much for the European psychologists, so the author took them on a tour.  These were the so called primative people who did not have all the benefits of civilization!  The aberrant were rare.  In our society they are common.  Check your neighbors.  On drugs legal and illegal, alcohol, divorced, in and out of jail. It hardly matters whether you neighborhood is an upper class one or a lower class one.  A little more or less decorum. 

Is this the bargain: you can either be healthy and sane but without the gadgets of civilization; or here, take this I-phone, this lap top, this auto, this psych med, this plane trip to Paris and be stark raving mad.  Unfortunately someone else at another time made the deal.  We are the heirs apparent. 

 
Lamy Avatari
on Feb 20, 2014

I think community can play the roles I suggested in my question, but know of only 4 or 5 examples of communities functioning in this way.

 
Lamy Avatari
on Feb 20, 2014

Thank you, John!  The book you recommended is just what I am talking about:  http://www.goodreads.com/book/show/328149.Original_Wisdom 

 
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Yuki Nakamura
on Feb 14, 2014 - 12:28 pm

The relationship between psychology with the social, historical and political context and how it serves to modify and label people as "mentally ill" is a mechanism difficult to identify. The problem might be then, how social therapy can be used to escape from this restrictive social structure.

 

 

Responses(1)

jennifer bullock
on Feb 14, 2014

Thanks for this comment.  It makes me think of how psychology as an institution in relation to the broader social, historical, political context not only serves to modify, label people as mentally ill as you  point out, but also modifies and boxes us in in relation to what we all can think of as right, normal, healthy behavior without questioning why we do our lives the way we do.  In other words, we don't even need to be labeled as mentally ill to be constrained by societally sanctioned ideals of normalcy and what is healthy.   

In one of my social therapy groups in Philadelphia, we are actively struggling with and working together on societal assumptions of healthy partnerships & friendships.  Group is working with one newly married member around the question of who is on the side of the relationship? What does that mean/look like to be on the side of the relationship?  What kind of partnership do you want to have? Is the partnership loving and friendly if it follows unquestioned traditional guidelines of gender roles, power dynamics, unspoken expectations of eachother?  Can the couple grow without developing a bigger life in addition to/outside of the marriage? 

This same group is  also  grappling with  questions of how and whether to build friendships 'outside' of the therapy group:  what do we mean by outside/inside - isn't group  in  our lives? What  are we taught about how we do friendships and how we do therapy?  What assumptions might we  question out loud? This came up because two group members are in a fight stemming from activities, choices, 'secrets' they kept from the group until things blew up, then they brought group in on the issue.  This is such a wonderful opportunity to look at how we can be unfriendly in  societally-defined normal friendships, how we can leave our groups to do things privately, in a society that worshsips the right to privacy and says that privacy, my businsess is mine only, self-determination, independence is unquestionably valued as healthy. But in this situation where two friends kept private some difficult therapeutically relivant issues until things blew up shows  the importance of questioning such broader assumptions of the right to keep things private.  What role does privacy serve, ie) what do we get out of it?  What does it raise for us to live more collectively and to participate in a therapy that is collective?

What do folks think about these questions being produced in my therapy group?

 
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Sarah Lyons
on Feb 13, 2014 - 3:17 pm

Thanks Jenn for the Facebook invite to participate in the dialogue on this snowy day. I'm writing from Staten Island, NY. Found Vesna's comments and Lisa Kimballs response very poetic. They helped to draw me into the conversation. When I think of the question of how to create mental health, I think about the challenge of doing that in a world where there is less and less meaning. Sometimes I think trying to create meaning in a meaningless world (by that I'm referring to one where knowing is less and less relevant and has less and less "traction" and ability to move us forward) ...anyway...that trying to create meaning, even collectively, can be very strenusous and painful because it's just not there to be had in he same ways it was historically.  That's when pointless activity can be so liberating ...and it's hard sometimes to let go of the promise that knowing once provided to our species and go in the direction of pointlessness. I think of the words from a Fred Newman poem (For the love of Rie and the Revolution) which always touch me deeply. Newman wrote "...I've always hated language, for its failure to fulfill its promise..."  He speaks to the built in promise language comes with ...to connect us and bind us...and the profound disappointment of discovering its limitations ...so we go on...as the poem does ..."Perhaps never more so then now, in the midst of this passion and frustration, I search for more and more ways to touch you..." As you know, I've been a political activist for over 20 years and poured heart and soul into resuscitating American democracy. Sometimes the gains in that endeavor are so modest, so hard to see, it feels like they don't even exist. But even if that were the case...even if the effort was a complete failure, I'd have to think we acheived, in our failure, a degree of meaninglessness, of pointlessness, that for our time, oddly, might turn out to be not only relevant, but useful. These are such strange and challenging times!  Thanks again for the forum and the opportunity to complete some thoughts with you.

 

Responses(1)

jennifer bullock
on Feb 13, 2014

Very touching Sarah...powerful way to continue the poem so to speak. Your leadership  is so valuable:  pointlessness & meaninglessness in this changing time where Knowing no longer takes us anywhere - and holds us back -  is ironically useful.  Quite thought provoking. Yes, and  perhaps what meaning is, and how create meaning is changing / needs to change in the conceptual revolution we are all in the process of building together.   Thank You.

 
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Yemayah Alston-Patterson
on Feb 13, 2014 - 12:51 pm

When I think of the subject of mental health so many emotions and concerns come up for me. From my own personal experience with "traditional" therapy to how children are over prescribed medicine to make them behave and sit still.  I disturbs me when I visit my doctor every 5-6 months when he spends an average of 10 minutes with me before he scribbles on his little pad and hands me my scripts. Before he calls my name I observe at least 5 other patients go in to see him. They too get up to 19 minutes of his time (or less).  I have even told him which medicine I wanted.  There's very little conversation. It appears that he doesn't care to listen to me. This is extremely problematic.  I often leave the doctor's office feeling confused, depressed and very pissed off.  

My point here is that this current climate of microwaved quick fix approaches does not work.  I think there needs to be more relationship building, compassion, and sincere caring.  

 

Responses(1)

Lisa Kimball
on Feb 13, 2014

I'm so sorry that you both had to go through that.  I tell my daughter all the time that yes school can suck but it doesn't need to be perfect to learn something.  I'm always at the edge of homeschooling but I don't because I think she still gets something of value. Children, especially boys aren't meant to sit for those long hours. My daughter is an avid reader, she worships authors instead of celebrities and she remains suspcious of organized anything.

 
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Aaron Feinstein
on Feb 13, 2014 - 12:44 pm

I am very interested in this dialog. I know several individuals who find great strength and community in their diagnosis. I think in relationship to disability this can be a very interesting topic. How do we provide accomodations for folks who have mental health diagnosis that may make it difficult for them in certain aspects of our society-and by embracing the diagnosis they find strength in numbers, and in like minded individuals.  I also wrote an article below on the shootings in DC in relationship to mental health diagnosis as stigma. So I am conflicted-I think diagnosis can be a powerful community builder, and I also think it can be a great source of shame and conflict.

 

 

Responses(3)

jennifer bullock
on Feb 13, 2014

Thank you Aaron.  I am glad you are sharing your thoughts here.  What an important conflict you share  - that diagnoses can at the same time be an avenue for connection & community as well as a trap, a box from which growth is stiffled. And perhaps it is a conflict not needing resolution but for us all to  hold, see, build with together in our conversations. I look forward to reading your article.

 
Hugh Polk
on Feb 14, 2014

Aaron,

There is no doubt that people often find comfort in getting a psychiatric diagnosis.  I think that speaks volumes to how starved Americans (and other people as well) are for the sense and experience of community, of being part of something bigger than “mySELF.”  The question is, “Are we willing to settle for the powers that be (the dominant institutions of society) defining what community we’re going to be part of?”  A community of isolated individuals with psychological problems who find solace with other similar victims?   I think we need to create community in which we build the kinds of communities we want to build for the good of all of us.  Part of that building needs to be creating new emotionality, values, attitudes.  But in our world where so many of us feel painfully isolated it’s enormously attractive and seductive to be enticed into feeling part of something, even if it’s a community of shared pathology.  How do we move beyond this?

 
Aaron Feinstein
on Feb 17, 2014

Dear Hugh,

It's interesting that you call people with diagnosis "victims" because they subscribe to a system that may offer them accomodations  because of their diagnosis or disability-and potentially a community. I am the Director of The Miracle Project and we create original peices of musical theater written and performed by people with autism, disabilities, and their peers and siblings. We create community that is not based on diagnosis, but based on accomodation and creativity through supporting and advocating for individuals who many times feel voiceless in their schools and therapies. In a sense, we are "therapuetic," but we do not practive therapy which is based on fixing people. We do not want to fix anyone, but rather give people creative opportunities to express and create and share their voices within a community. We also pride ourselves on celebrating autism and disability. So I think victim is a harsh word-I think diagnosis can help people relaize that their are others and then encourage the individual or group to advocate in their community. I see the members of The Miracle Project as advocates for autism, creativity, and community.

 

 
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Anthony Kimball
on Feb 13, 2014 - 12:24 am

Hello everyone,

I find this to be quite an emotional conversation. It seems we all have reactions to the activity of "labling" one another. I know I do...it seems so de-humanizing. I think, as Jennifer said, it does have "everything to do with the pain and disappointments we experience with our mental health and educational institutions. "I never understood that having a label placed on me severly limited my ability to "be" more than that label (until I was exposed to social therapy).

I was having  a conversation with Lisa earlier, off of what we read here about what "Mental Illness" is. I think it's a label society applies to a person's behavior when society is uncomfortable with that behavior. Identify it, put it in a box, and keep it away from "normal" people ( however you define that...thank you Aaron, Hugh).If I may make a pun, one problem with labels is that they stick. we get stuck inside them, they get stuck to us. I am concerned what effect these labels may have on our daughter. We do relate to our dughter as other than/ more than this label, but it often feels like we are the only ones.

So yes, I too see clearly the relationship between relating to people as having to be fixed and Psychology's connection to the "social fabric". It may be too soon in this coversation, but this seems to raise a serious practical question of how we go about changing societal perceptions toward what mental illness is, and the questionable value of the diagnostic paradigm. Maybe before we get to the "how", we need to ask if we think it is even possible? 

 

Responses(4)

Elouise Joseph
on Feb 13, 2014

Thank you Anthony. I agree. We all want to belong to the group and labeling places us outside of the group--turns us in to "the other". I like your pointing out that the label is applied to constrain "uncomfortable behavior". I am reminded of the shock I felt when I learned that in 1861, Samuel Cartwright, a Louisiana physician had created a "label" for slaves who had a tendency to run away--drapetomania--"the disease causing negroes to run away [from captivity]". It's when someone like Dr. Cartwright has the authority to create a label that it becomes important. I think the ADD/ADHD label is an example of this because when you think about it there is no "deficit" of attention, quite the contrary. And to your last point and question, yes, it is possible to change societal perceptions. We have begun.

 
jennifer bullock
on Feb 13, 2014

Quite a moving statement Anthony,  thank you and Elouise for your response. 

Yes, And... we have begun, together, to change 'societal perceptions'.   Every person creating this conversation together and every person/grouping participating in new ways of relating, growing, learning and healing is making a conceptual revolution, as Lois Holzman offers in her work.

 
Yemayah Alston-Patterson
on Feb 13, 2014

I hear your frustration on the labeling and being put in a box.  We need a society that accepts the truth; that everyone is unique and different.  Our differences make us interesting instead of abnormal or "crazy".  I have decided to speak out about my own "label" instead of being ashamed and hiding from it.  I think it helps people to see that while I may have an diagnosis, I am still very much a part of whatever I am engaged in At the moment.  

 
jennifer bullock
on Feb 13, 2014

Right on Yemayah!

 

 

 
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jennifer bullock
From the Moderator: jennifer bullock
on Feb 12, 2014 - 2:00 pm

I am loving this stream of powerful comments and thoughts this week.  This is what I am hearing, what do you think?  And keep inviting your contacts and clients to join in on the dialogue!

The social-historical-political perspective you offer Vesna (via Serbia) adds so much to our conversation stream  - thank you.   It is so very critical to see how our cultural and political History has everything to do with our collective and individual mental health,  as well as what gets legitimized as Psychology / treatment, as Annalie (via South Africa) added. Your responses to Vesna,  Barbara Patrizzi (via Philadelphia) I think is spot on. 

As Vesna suggests, one part of the American Zeitgeist which could arguably come from a political history of hysteria, violence, domination, can-do-anything perspective leads us to unquestioned assumptions about how we see difficulties, pain, 'problems', ambiguities, relationships, health: 

We can control, fix, win anything, we can and need to have clear categories, explanations, labels, quick fixes for individuals.  What if this has something(or everything) to do with the pain and disappointments we experience with our mental health and educational institutions that, for example, Evangelos and Lisa so eloquently speak to in their attemps to work with school systems on behalf of their children?   

The need for emotional healing and growth as well as environments for learning via creativity, play, improv, that Raquell and others speak to are difficult yet perhaps so important to build together when our institutions of learning and mental health are dominated by hyper-individualistic, medicalized, so-called evidence-based models of mental health, mental illness and learning (eg - my  mental health issue or learning 'disability'  is a problem inside of me that needs a proven,  standardized, medical-like intervention).  

I appreciate our thoughtfulness, intriguing perspectives and responses to one another.   What do you think?

 
Lisa Kimball
on Feb 11, 2014 - 6:05 pm

Everyday I send my daughter to school in a building that has questionable safety procedures and fails to support her developement as a creative being. It is an imperfect situation that I question as a parent if I'm doing the right thing. We live in a small town, which is really nice. Her childhood has been totally different than the one that her parents had. She's had close connections to friends right in the neighborhood and has lots of experience playing with caterpillars and playing in the woods. I love her, but I hate being a parent. Oops, let me explain. Social expectations, panic and conformity are repressive and draining. It seems the design of the education system swallows the depth of what it means to be human.

My daughter Cheyanna hasn't had an easy time of it.  There are two memories planted in my brain that I found so odd. Reading Recovery which is a intervention program. Parents were invited to view how this program worked. I attended the meeting where they showed us this two way mirror where they analyzed the actions of the kids. I can't say why my reaction was different than other parents. But Cheyanna, being only five at the time and my understanding as a parent as to how she had learned up until this point was through social interaction and love. Somehow the mirror thing didn't run along those lines. My second thought was wow they spent a lot of money on that. I think I recall they gave us those numbers, which were large. But it all costs a lot, the mirrors the special programs the drugs given to kids, common core, etc. We kept her in reading recovery. But we were perplexed that she was in fact in reading recovery when all we did was read to her and our outings consisted of Barnes and Nobles. Another memory I will always have is going into the district office to get forms to have her evaluated. We were confused and didn't know how to help her. We never got her evaluated.

We got off that treadmill of labeling. I think we didn't go down that path because Anthony and I were both in Social Therapy for many years and we looked at the situation a lot differently. We understood that she didn't fit into a box or version of what the school thought  a five year old was supposed to be. But it was hard, harder for her. She understood at five she was singled out in a way and expressed to us that she wasn't a good reader and in her five year old way she communicated that it hurt her. She was lucky that she had some amazing teachers that were very loving to her and gave her the extra that she needed to build her confidence. I know other children aren't so lucky.

 

 

Responses(3)

Yemayah Alston-Patterson
on Feb 13, 2014

Kudos to you and your husband for standing for your daughter.  This moved me very much.  I remember when I went to a parent/teacher conference for my son, then in middle school, and his teacher rambled on negatively about him. When I asked her if she could come up with one positive thing to say about my son, she could not.  I told her that she was the problem. Some time after the school suggested that my son go into special education class. He had an IEP.  I was confused and overwhelmed. I probably should have gotten a lawyer but I couldn't afford one.  My son spent one school year in a special ed class where little to no instruction took place.  It was like a zoo.  I felt like a failure as a parent. I eventually got him out of there but who's to say what damage he experienced to his psyche. Writing about this I can still feel some emotions about it.  My son is almost 21 but his educational experience within the public school system was very flawed.  

 
John Burns
on Feb 16, 2014

Are children at the age of five expected to read?  I don't believe mine were.  This sounds like teachers trying to please some state program that is misguided.

 
Lisa Kimball
on Feb 20, 2014

I think they have stages they think the child is supposed to meet. I know that they've moved away from sounding out words.

 

 
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Jeffrey Aron
on Feb 11, 2014 - 3:33 pm

Thank you for beginning this conversation. I look forward to creating it with you.

 
Evangelos Courpas
on Feb 11, 2014 - 11:22 am

Hi just joining the conversation,

I have spent time in social therapy groups with Jonathan Sulkin in upstate NY and Murray Dabby in Atlanta. I have a 7 year old son who has been diagnosed with ADHD and he takes focalin. We are looking to end his use of that drug next school year. In my past, I have struggled with entrenched personal narratives of victimization and anger/ depression. I wonder about the relationship of cultural/personal narratives to both violent acts in our schools, as well as, a general discord between so many parts of our population. I am interested in both the naratives and how we prescibe them. I accept so many cultual narratives because they are the norm. Like accepting that my son will take a drug so that he might work effectively or in sinc within the expectations of his shcool/classroom. 

 

Responses(1)

Barbara Patrizzi
on Feb 11, 2014

Yes, Jenn. I do see these common threads. Our mental health system treats us as if we are just individuals with individual problems. It is clear, however, that our whole world is completely out of balance. Most therapies and no drugs address this fact.

Why medicate someone who is mildly or even moderately depressed or anxious when it is completely understandable that people are depressed and anxious in the world we live in? Our alienated, individualistic, consumerist way of living and thinking is effecting us all.

Medications certainly have a place for some people, but drugs can not "fix" what is wrong with our world. That will take much harder work from all of us, and a different way of approaching mental health - an approach like what Raquell speaks about.

Vesna's comment  makes me think about our American propensity to want to fix everything (often with medications) and have everything be easy. We are uncomfortable with discomfort and difficulty. Other cultures are more accepting that discomfort and difficulty are part of life to be dealt with together as a community.

I don't mean to sound hopeless, because there are plenty of hopeful things happening in our world as well. But to fix what is causing pain and discomfort in our lives will take more than pills. We shoudn't let the drug manufacturers convince us otherwise.

 
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jennifer bullock
From the Moderator: jennifer bullock
on Feb 11, 2014 - 10:47 am

What I am taking from some of the recent comments/questions:

1) Focusing solely or mainly on the individual as the object to fix is not only unhelpful but also harmful. It's the group / the social / the relationship / the community that needs 'intervention' & can grow and develop.

2) Psychology is not neutral or separate from the political-social -cultural fabric of the world,  and to claim such is not only inaccurate but also dangerous. Therapy is personal, subjective, and political.

Do we see a relationship between these two points?  And if so what is the relationship?

 

Responses(5)

christine lacerva
on Feb 11, 2014

Hello everyone -

The following is a response from a dear colleague of ours, Vesna Ognjenovic, of Zdravo da Ste ("Hi Neighbor") in Belgrade, Serbia:

"Sometimes logic makes sense ... simply sad and observed from a distance. The American Society probably is in an emotional crisis, which is different from the emotional crisis that has shaken Europe. The two social systems still have somewhat similarities .. both a value system built on optimism, pragmatism, rationalism and consumerism as an economic basis, incorporating two different myths in the subconscious of people. .To Americans  it is that they are the strongest, freest, born to run ..it  is deeply ingrained in all of American products and life style and some time for expansion of this model was not required objectives  are... army assembly ..the model is functioned as the paradigm of modern, fast, all-knowing man ... myth inplanted in European countries to their citizens .. we live in the alleged , ancient and multi-layered culture, based on the history and knowledge .. these two models were in conflict and the conflict is still there...But, emotional problems of citizens of both areas derive from the lack of will to explain to them that what they now already feel like their identity in things created by teams, whose task is the  homogenization of the masses ... in America that produced hysteria and aggression as the most dangerous forms of morbidity.... In Europe myth the culture and history has produced immeasurable melancholy and depression ..."

 
Lisa Kimball
on Feb 13, 2014

Thanks Christine for posting Vesna's response. It is very insightful to hear someone's perspective from another part of the world. I had spent three weeks, two summers ago in Zman, Croatia. I often feel that the story, The American Story is a story that is hard to understand without hearing multiple stories from others. Anyway, during my visit in Croatia I thought a lot about language and dialogue, partly because there is this desire for the Croatian language to continue. "Do you speak Croatian?" I don't. Regardless, I attended their storytime in the village where people sing, tell stories and poems. My cousin asked why I went if I didn't understand anything. I really didn't feel I had to understand the language to have what they were doing. So here we all are on a blog with words, words filled  with care and desire to find. People are writing about important stuff. And it does seem it's hard to understand ourselves and our struggles and find our way out of sadness when were part of a societal construction. I said to someone the other day that we're part of the largest human psychological breeding program. I came to that term and what I mean is, we have abandoned what is is to be human. So much of what is considered imperfections are just part of who we are. Much like how the AKC determines what a purebreed dog is by looks, not by ability to do the task that was orginally intended. When we use the word Mental Health, as Diane Whitehouse questioned. I often feel those words are final words in society. Meaning, beyond understanding or able for others to deal with. Our society seems to speak a lot about gun control but we seldom take on Mental Health conversations when perhapes these should be everyday conversations. 

 

 

 
Yemayah Alston-Patterson
on Feb 13, 2014

I wonder what it would take for our society to embrace the idea that we are NOT one size fits all but that each person is a unique creative expressions and nuances. It's very sad that people are shunned, medicated, labeled, and abused just because they don't fit.  

 
Hugh Polk
on Feb 14, 2014

Vesna,

So good to hear your intelligent, political and poetic voice.  You point to something that is so hard for us Americans to understand:  society and history produce our emotionality, attitudes and values.  Americans have taken the institution of psychology and used it to create an extreme attitude that the individual can be “the strongest, freest, born to run,” as you say.  And that has produced “hysteria and aggression as the most dangerous forms of morbidity,” as you also say.  I think we need to create from the bottom up a new understanding and practice of human beings as social, collective, responsible to each other in building a new psychology of social growth and development of and for all.  Your voice is important in that.  Thank you.

 

 

 
Baylah Wolfe
on Feb 28, 2014

 

Jenn, I am grappling with how to respond to your question about the relationship between the pull to focus on and/or to fix the individual, rather than to intervene on the group/the social/the relationship/the community and importantly the assertion that psychology is not neutral, in other words, not separate from the context in which the ‘science’ was created.

 

 As a young adult in my twenties, my mother became angry with me for taking some distance; I didn’t call her for 2 weeks. I was struggling with some issues around my sexuality.  This was in the early 70’s when the anti-war, human potential, women’s and the gay movements were flourishing. Though my mother and I had been close, she decided to cut off her relationship with me.  I was no longer invited to family gatherings; this went on for months. I also got a letter from my father, in which he said I must have a defect otherwise this would not have happened. I carried around the frayed paper in my wallet for years. This estrangement from my family totally consumed with me for some time. When people understand their emotional problems as defects within themselves, they are disempowered. The focus on the self saps energy.There was no way I that I could do anything to be an active creator of my life.

 

Freud asserted that civilization is as it is because of the basic inner nature of human beings.  i.e. the Id, the Ego and the Superego. The world ‘as it is’ is a reflection of those intra-psychic conflicts. This stunned me!  Human agency is nowhere on the horizon.

 

Traditionally trained psychologists psychiatrists and clinical social workers are programmed to accept the unassailable truth that ‘scientific or evidence-based’ psychology is ‘objective’. Research, so the story goes, is conducted in such ways as to control for bias; eliminate subjectivity and distortions of the research team. Yet how can this be so?  For example, race and class biases are embedded in language; they inform what and how we see. We see particulars, individuals, not groupings, not wholes, not gestalts.

 

 Years ago, I became a radical therapist in private practice, explaining people’s problems as having stemmed from the isms – racism, classism, sexism and homophobia. The tagline on my business card was: If you don’t want to adjust to the world as it is…

 

 What I did not see was that explanations - either of intra-psychic phenomenon or sociological ‘causes’, is not neutral! It is the historical moment we’re in that has produced scientific psychology with its focus on the individual.  When things are explained (away) they are fixed. This is dangerous. As Dr. Polk says, people are alienated from the fact that in addition to being determined by the conditions of the world, we are also the creators and potential changers of the world.

 

 
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raquell holmes
on Feb 10, 2014 - 7:47 pm

Hi Hugh and all, I'm just joining the conversation. I am concerned about the increase in shootings in "public" places. And mostly because I think we're leaving people, in this case young people, alone to such degrees that kids are shooting. 

it's not new. it's at a new level or in a new demographic. I hear teachers talking about no one knowing what to do to help the kids that are "acting out" in their classrooms. They are asking for help and folks don't know what to do. 

I find hope in some places where schools are adding structured games to recess to help kids navigate social spaces, having recess!. It frightens me that we are mandating kids to be in a school environment without play. 

I am eager for conversations and activities that have us getting to know one another, to be with each other in what can be awful conditions or joyous moments. I believe individuals are looking for someone, something that they can be part of that helps them to be in less emotional pain. Does it have to be therapy? Counseling? Coaching?

Social therapy is so aptly named. We need something socially, and in terms of our social health we are in need of creating our health. I think that's usually said as therapy. 

 

 
Barbara Patrizzi
on Feb 10, 2014 - 4:49 pm

Hello All,

I am not a mental health professional, but I am someone interested in making the world a healthier place for all living things. Many of the comments so far seem to speak about the need to get away from labels, diagnoses and medication as the first line of treatment for people in crisis. We operate as if the act of labelling and medicating will "take away" the pain, anxiety, depression, distraction, or whatever, that so many of us feel in our day-to-day lives.

People do seem to take some comfort in having a label for their pain, as if it will justify their behaviors, or serve as the first step in a "cure".  But maybe all this focus on individuals and their particular quirks is obscuring the real problem, which, as I see it, is that the world is completely out of balance.

We live in a world that is not well, as Jennifer has often said. Things around us are frightening, alienating, and often downright unhealthy. Schools are not serving our youth, and we are not serving each other. Maybe it is not individuals that need to be "fixed" so much as it is the way we all relate to each other and our world.

 

 
jennifer bullock
From the Moderator: jennifer bullock
on Feb 10, 2014 - 3:06 pm

Hello - Jenn Bullock here, Director of the Philadelphia Social Therapy Group.  Hugh Polk has passed the baton to me to moderate our conversation for the week of 2/10/14.

I am very excited to continue this engaging and important dialogue.  As a group psychotherapist, youth advocate, and political activist passionately concerned with how we are doing in the world together, I so appreciate the array of thoughtful comments so far regarding What is mental health and how do we – together - create it? 

I encourage folks who have joined in on the dialogue to invite colleagues, friends and clients, to continue adding your thoughts, and to respond to one another. 

The richness of the first week’s conversation is inspiring:

From our increasing concerns with over-diagnosing and medicating as a first line of treatment, particularly the most marginalized, to other-ing clients as objects to fix or analyze…

From the desire for approaches towards mental health that are more creative and collaborative,  to questioning where mental health is actually located:  inside an individual and/or in communities?

And asking ‘What is normal and who gets to decide?’…

I very much look forward to what we will create together this week, and please spread the word to you networks, all are invited to share.

 
Ramon Pena
on Feb 10, 2014 - 1:57 pm

I have been curious about this for a long time. I hear many people in regular traditional therapy say how it has helped them. I am a little confused. So the question I have is this not true? and if it is not why would people say that kind of therapy helps? This could go to all the doctors..

 

Responses(2)

christine lacerva
on Feb 10, 2014

 Hi Ramon

I like your question here. People can get help from all kinds of therapies. It is a very personal experience.  In my work as a therapist I am challenging what people mean by help. Often the answer is to  help people feel better. However growth and development do not always feel good! Developing and growing are social and can emerge from hard conversations, pain, frustration and anger. The process can be diffcult . Doing therapy in groups helps create the environment where the group can grow together--deal with the emotional pain of our lives and sometimes the pain and joy of growing beyond ourselves. 

 

 
Yemayah Alston-Patterson
on Feb 13, 2014

I thought traditional therapy (and I've had a lot) was helpful BEFORE I was exposed to Social Therapy.  Social Therapy helped me see that traditional therapy is so limiting.  There are too many rules and not enough room for creativity.  Traditional therapy, as you probably know, focused more on your past and how that has shaped who you have become.  While ST focusing more on building who you want to become.  Im more interested in that. 

 
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Ramon Pena
on Feb 10, 2014 - 1:03 pm

This is great Dr. Polk, I stumbled on this thanks to facebook. So I would like to hear about mental health and depression. Why would a General Physician deal with a persons depression by medicating them with ambien? I would like to get some feedback in to why this would take place? Thanks

 

Responses(1)

Hugh Polk
on Feb 10, 2014

Ramon,

Hi!  How are you?  So great to have your voice in this conversation.  Psychiatry has gone in the direction of understanding depression and other emotional problems as biochemical and are working with the drug companies to get all of us on board with that.  They’ve spent untold billions of dollars and have largely succeeded.  Other doctors. as well as the general public,  have bought in to it.  However, there is a movement building to not just diagnose and medicate people but for mental health workers and clients to together create new ways for people to get help with depression that don’t rely on medication.  Read the other comments on this conversation, Ramon, and you’ll see what I mean.  Hope to see you soon.

Hugh

 
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Evelyn  Dougherty
on Feb 09, 2014 - 3:34 pm

Hugh, thanks for your thoughts.  I work in both a traditional mental health setting and a social therapy practice and see daily the limits of the "medical model" in the traditional setting. I feel that psychology perhaps in trying to be more legitimate? has taken on the aspects of the physical health model and thus diagnoses and presribes medications and labels people when I believe psychology is so so different.  Yes there is pain - but emotional suffering is so different from physical and I think so responsive to transformation.  Social therapy in it's group activity where creativity, performance and philosophical questions are encouraged in my experience (as a practitioner and patient) is emotionally curative!

 
Yuki Nakamura
on Feb 08, 2014 - 9:13 am

Greetings to everyone! For a long time mental health has been the basic way in which members of a society have been divided and labelled. Divided into what? why? The answers here, as well as the questions can be more complex that what it seems at first. If one thinks about it, the divisions and categorizations between people who are mentally "healthy" or "ill" can be seen throughtout society: sane/insane, good student/bad student, deviant/good citizen and so on. The post given by Elouise Joseph below, of how students, even CHILDREN are evaluated as "bad" students show that mental health, disguised as expertise is used in almost every field of ou daily lives in order to categorize people. The question here is then, how do we get out of this system? Using social therapy? Try to avoid the categorizations that we create when interacting with other people? Or we look for the answers by interacting with other people while at the same time we discover ourselves?

 

Responses(1)

jennifer bullock
on Feb 09, 2014

Thank you for this comment Yuki - how did you come across this dialogue?  I appreciate the point you make about the societal damage done by a hierarchy of labelers who are legitimized to categorize the labeled, and as you say, creating a divided society.  I am glad you and we are asking hard questions without clear answers.  Your last question on how to get out of this system is intriguing and makes me think of a quote by Fred Newman, philosopher and a founder of the social therapy approach "the only things worth knowing about another human being are what you learn in the activity of building something together...For what we create [together] is an extension - a continuation, a completion - of ourselves."  I look forward to more questions and comments.

 

 
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jennifer bullock
on Feb 06, 2014 - 6:30 pm

I appreciate a question I hear in some of the comments so far:  What new approaches can we practice in collaboration with clients that move us away from ineffective, conventional medical-model interventions that leaves individuals, families, schools, communities in continued crisis?  I just read a wonderful article Dr Ron Taffel, a leading adolescent and family therapist titled 'Helping Today's Parents: How to Build a Parent Community.' He speaks so eloquently about the need for interventions to improve mental health that are community focused - that mental health is in fact located in our communities, not inside individuals. That perspective changes the whole game re:  how clients and practitioners can work together.

 

 
Hugh Polk
From the Moderator: Hugh Polk
on Feb 05, 2014 - 6:43 pm

Most of the practitioners who’ve posted comments have expressed your concerns about the limitations of diagnosis and your feelings of being trapped in a system that requires it.  I’ve certainly felt that way myself when I have worked in similar settings.  Is there anything we can do to free our patients/clients, and ourselves, from the trap? One thing that I’ve found effective in all the places I’ve worked – including inpatient units in psychiatric hospitals – is to ask my patients if they want to work with me to figure out how to create the treatment together. I make it clear that as a practitioner I don’t have the answers, that I can’t fix them - but that I do have skills and experience that can be helpful.   I say – and I mean it – that they’re not a problem to be fixed nor an object to be labeled - ­­­they’re a creator of their life.  I’m here to collaborate with them in creating the cure.  The question is “How shall we create this treatment together?”  Then you’ll have to deal with them saying they don’t know what you’re talking about!  But that’s OK.  They don’t have to know, they just have to be willing to do the not-knowing work of building it with you.  When you’re doing this with your clients, you’re not diagnosing or labeling them, you’re creating growth with them as partners.                                                             

Elouise, Helen, Shane, Baylah, Cathy – I think doing this will help you – and them – to break free from the diagnostic trap.  Have you tried some version of this? Tell us what that’s been like. Does relating to your patients/clients raise conflicts for you? And in the spirit of what I’m saying, I’m eager to hear what those of you who are therapy patients/clients think about all this.  P.S. to Diane, please say more about what you were thinking about in writing your post.

Hugh Polk

 

Responses(2)

Esben Wilstrup
on Feb 07, 2014

I am very moved by how you relate to your clients (even and especially in inpatient units in psychiatric hospitals). I'm currently in Oslo for a theatre of the oppressed workshop led by Hector Aristizabal whom I believe you also know. The title for the workshop is: Humanizing "The Other", which I think is an apt description for what you are doing with your clients - so that both Client and Professional become human beings - engaged in the improvisational activity of creating treatment together.- "that they’re not a problem to be fixed nor an object to be labeled - ­­­they’re a creator of their life.  I’m here to collaborate with them in creating the cure. The question is “How shall we create this treatment together?” " 

 
Shane King
on Feb 07, 2014

I think collaborating is the best approach we should strive to do with clients. We should collaborate with the client towards their vision of change. Meeting them exactly where they are and looking at the situation from every prospective and saying how what I feel if I were in your shoes.  I occasionally try not to look at myself as a counselor sometimes but as a life coach trying to guide my client through the rough patches of life. Something that I learned very quickly is that the client is not the problem and the problem is the problem and the client is the one dealing with the problem.  I try to help clients find a separation from themselves and the problem because they sometimes have a belief that they are the problem. Once we can define (assess) what the problem is, we can start peeling away the problem piece by piece through carefully thought out interventions.  I use to have trouble relating to clients but I no longer have that issue. I find ways to relate to them because of my love for humanity and my belief that it is the relationship between client and worker that will increase that greatest drive towards change. I still struggle occasionally like others with counter-transference I do not think it is something you run from.  I challenge myself to stay conscious and aware of how it can become a potential barrier.  I am going through it now in a current case however; I talk things out with my colleagues and create a mentally safe space where I remove myself from the situation so I can understand why the situation is happening (why is it functional), remain present focus with the client, actively participant without actively feeding the situation, and truly understanding where they are with the situation as it is occurring. These are the steps I take to maintain a meaningful working relationship with my clients. I am still a work in process but I think as long as we are willing to acknowledge our barriers and struggles we can be the catalyst for change. I think we are all in the life changing business and we cannot beat ourselves up when things do not go as plan but challenge ourselves to continue to collaborate with our clients as a working team towards developing realistic and sustainable outcomes.

 
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Esben Wilstrup
on Feb 05, 2014 - 4:46 pm

Joining you from Denmark! Looking forward to creating conversation, community and discoveries with you! 

 
Hugh Polk
From the Moderator: Hugh Polk
on Feb 05, 2014 - 8:10 am

To Shane King (see his post from yesterday): Thanks, Shane, for your comments.  You raise many important issues.  Let me respond to one of them now: your comments about the need for activism. I think an important question here is what form does that activism need to take?  For me as a psychiatrist I have had to grapple with that question. I decided I needed to build independent institutions where groupings of therapists, educators, researchers, clients and political activists could work together to create a new psychology.  A psychology that in its very activity shows that you can help people grow and develop without diagnosing them. In that setting you can challenge the notion of the primacy of the individual psyche--the standard practice today--and build diverse groupings of people where the focus is on group creativity. The question becomes how can we create an environment where the group can become more powerful--where the group works in collaboration with the therapist to create their therapy together. That's the path I took.  It is an exploratory collectively created path focused on development. Activism is key. There are other paths where activism can be practiced.  I would love to hear from others on this important question Shane raises. Thanks for your response, Shane.

 

Hugh Polk

 

Responses(2)

Annalie Pistorius
on Feb 07, 2014

Thank you Hugh, and Shane, I think we need activism on many paths - as mental health workers we need to become aware of how the psychology that we are building and practicing is part of a dominant culture or politic that we are perhaps taking for granted. For example, in the Apartheid South Africa, psychologists were practicing psychology as if the government politics had nothing to do with them, they were neutral and thought they could do their psychology seperate from politics (as prescribed by Western norms for the Science of Psychology). A few liberal psychologists however joined the activist route and made people aware that psychology is not value free and that the develpment of psychology should be community-based, organic and participatory. It helped us to join the Anti-Apartheid movement, and this made us much stronger in moving forward. Take for example, what are we doing currently about the debate about American psychologists serving the US army who had participated in using torture in interrogations of terrorists? Is this just an interesting and shocking debate I am/we are listening to while I /we keep to my/ourselves as not being part of it? OK the last bit is just to strir our coversation a bit;)  

 
Hugh Polk
on Feb 10, 2014

 Annalie,

Thanks for introducing politics into this dialogue.  Thanks for showing us how psychologists and other helping professionals commonly think the approaches we practice are politically neutral.  In addition, I think there is a political perspective embedded in the mainstream psychological approaches which attempt to help the individual with their emotional problems—namely, that they are trying to get the individual to adapt to society.  Many people who’ve responded in this conversation are struggling to create social, collaborative, developmental approaches where groupings of people--practitioners and clients together are creating communities of development.  I think this is a very different political perspective—namely, that groupings of people can change the world. 

Hugh Polk

 
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Annalie Pistorius
on Feb 05, 2014 - 3:11 am

Hi, I'm happy to be part of this conversation. I'm from South Africa - a psychologist in private practice and lecturer of psychology at a university here. 

 
Catherine Sadell Tatevosyan
on Feb 04, 2014 - 1:08 pm

Thanks for leading this and for all the good questions. Looking forward to talking about how we support children and teens to develop, among many other things.

 
Elouise Joseph
on Feb 04, 2014 - 2:41 am

Hello from Oakland California. I am so glad to be a part of this conversation. As a pediatrician, when I look at my schedule and see the word "Evaluation" as a reason for a child coming to see me, my heart sinks because it always means a mismatch with the school/teacher and the child has been branded as having attention deficit disorder with hyperactivity and the school principal or teacher wants him (usually) or her on medication. The "proof" of this is usually a subjective questionaire such as the Conner, completed and even scored by the teacher. I take a deep breath, step in to the room, say hello, and give the child a BIG hug. Then I speak with the child and his/her parent about options-including drugs.

 

Responses(4)

Aaron Siegel
on Feb 05, 2014

Elouise, I am heartened to hear your response.  From the parent side of your scenario, I am shocked by how frequently I hear teachers, paras, and adminstrators talk about students as though they were examples out of a textbook.  Having had my own run-ins with my son's teachers around these questions, I can tell you that it is really painful to see young people labeled and stigmatized because they don't fit the mold of a 'normal' student.  What is 'normal' anyway?

 
Hugh Polk
on Feb 06, 2014

Aaron,

 

“What is normal, anyway?”  What a great question! Especially because hardly anyone ever seems to think it's worth asking. Just about everyone who uses the word -- which is to say, just about everyone, not only in the fields of Psychology and Education, but in everyday life -- seems to assume that we all know, and agree on, what it means. This morning I found myself thinking of your question and the phrase, “the tyranny of the normal,” kept coming into my head.  It seems to me that “normal” is one of those conceptions used by the dominant societal institutions -- Education, Psychology, Politics, Religion -- to define who's who and what's what, thereby keeping all of us in our places and in turn stifling creativity, growth, possibility, new ways of doing things, the process of becoming. In my experience, people's subservience to “normal” often causes them enormous emotional pain. As you know, in our social therapy groups we don't try to help people to be normal (whatever that might mean). Rather, we support them to create their lives together with others. A big part of that work is to keep asking questions that normally go unasked, like "What is normal, anyway?" Thanks for it, Aaron. 

 
Shane King
on Feb 07, 2014

Greetings Shane King from NYC. I just want to share my thoughts on Hugh’s great points. I think what is normal has been determined by society and systems and institutions have adapted to that form of thinking. I think that plays a part in stripping us of our creativity and our ability to create and recreate. In a sense we are being programed or conditioned to think what is normal and not normal. However, when we can break free of that form of thinking and learn to process what we have been taught and challenge it. We can begin directing our energy into the work that is truly transforming and involves healing to our clients. I think that’s the main reason I want to do private practice because I don’t believe in the philosophy and ideology of the institutions especially the one I am currently working for. I still believe in talk therapy being the vehicle towards creating change any day over this revolutionary belief we as practitioners or psychiatric have to diagnose and medicate. These dialogues raise excellent questions that challenge our thinking about mental health and raises concern about the future of mental health services.

 
Catherine Sadell Tatevosyan
on Feb 12, 2014

Yes, thanks Elouise for raising this, and to others for opening up the question of what is "normal."  I have been asking myself whether it's "normal" for kids to sit for 6-7 hours in a classroom without wanting to move around.  Many kids in NYC get little  gym or recess time, if they have it at all. Many go home to hours of homework, followed by video games (if they are fortunate enough to have electronics), and sleep. Some do not get the opportunity to play with other kids outside of school, so not surprising they want to play when they are there! I see parents who are afraid to let their children play outside, often with good reason. Kids also sometimes deal with sadness or anxiety through hyperactive behavior, in my experience. Thanks to Hugh, Jen and others who are creating a non-diagnostic therapy where people can get help in dealing with whatever is really going on in their lives, without being labeled. (Sorry for the long response -- good to share thoughts with you all.)

 
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Darryl Diptee
on Feb 04, 2014 - 12:08 am

Glad to be a part of this discussion. 

 
Shane King
on Feb 03, 2014 - 10:20 pm

Greetings, Thank you for opening the dialogue for us to come together and talk. I am responding from NYC.  My concerns for mental health are consumers are being overly diagnosed and there is occasional misdiagnosed. We are living in an era where medication has become the problem solver and the quick fix. I am extremely alarmed at the many teens particularly of color who being impacted by the diagnoses especially ADHD. Mental health services have an immediate needs focus however, there should be more focus on the root core issues of people before making the decision to diagnose someone. There needs to be advocacy to change policies regarding who is qualified to control the diagnostic process because unaware and unconscious Psychiatrist can and are instruments in our consumer’s mental health destruction.  There needs to be activism to raise attention to how we want to transform mental health services as well as speaking out about side effects to medication while promoting the many forms of Therapy that educates, helps  practice preventive work and address  root core client issues. That requires insurance companies changing their views on how they decide to fund services and bringing a sense humanity into the views of the insurance companies that twinkles down into the mental health services. I live a very healthy life and I take nothing for granted.  I work-out at least twice a week, I set time aside to relax, I go out to community events to stimulate my mind, and I do a lot of praying. This has been working for me to strengthen my emotional life. I participant in activities that bring a sense of satisfaction and happiness to my life and health. I’ve changed my diet and have cut down on foods that may affect my health short term or long term. I try to eat a lot of naturally fresh foods.

 

Responses(1)

Elizabeth Bautista
on Feb 10, 2014

I agree with Shane's statement " There needs to be activism to raise attention to how we want to transform mental health services as well as speaking out about side effects to medication while promoting the many forms of Therapy that educates, helps  practice preventive work and address  root core client issues."

For those of us who are lucky enough to have "mental health service" as part of our benefit package, while it's nice to have it, it is usually of the more traditional package of "curing" what ails you with a type of psychiatric service or where you are prescribed a drug.  Not every situation needs this, in fact, we should consider that social theraputics can be used in many situations where drugs or psychiatry are the traditional cure.  

The mental health system today is based on community needs that are more than 50 years old and yet we continue to function today based on that model instead of developing criteria for future mental health needs. It will take both patient and practitioner to change our society's mindset and this conversation helps create the environment to make this happen. What do you think?

 
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Mark Balsam
on Feb 03, 2014 - 9:25 pm

Nice to be here with all of you. Should be very interesting!

 

 
Barbara Silverman
on Feb 03, 2014 - 5:59 pm

This is such an unusual opportunity to create a conversation with clients and colleagues.

 

 

 

Responses(1)

Ildiko Kemp
on Feb 03, 2014

Hi! Joining in from NYC and the East Side Institute. I am interested in public health and I feel that mental health should be more prominant in the feild of public health. I think often in public health, mental health is brushed aside as less important than bodily health and therefore not heavily addressed by policy makers. Also, I disagree that the medical/scienticif model is the best model to use when diagnosing/treating mental illnesses.

 
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Helen  Abel
on Feb 03, 2014 - 3:36 pm

Hi. Joining from San Francisco. To respond to part of the first question I think psychiatric diagnosis can be very limiting in how people see themselves. I have had many clients who come in the first time and describe themselves in terms of their diagnoses. People start seeing themselves as a label, rather than a complex human being.

 

Responses(1)

Diane Whitehouse
on Feb 03, 2014

Hi Helen, 

What do you do when you experience that happening with your patients?

 
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Gayle  Weintraub
on Feb 03, 2014 - 10:52 am

Hi Folks!

Looking forward to being part of this conversation!  (from Brooklyn, New York)

 
Diane Whitehouse
on Feb 03, 2014 - 8:52 am

So, what is mental health?  Is there a mental health in relation to our community? Or is it geared to us as individuals?  

 

Responses(3)

Ramon Pena
on Feb 10, 2014

I was wondering that myself Diane. I always thought mental health as being crazy. This is what I was taught as a young person. As I grew older I realize that I think mental health has a lot to do with emotions and past experiences, whether they are positive or negative and how we deal with them as individuals. I dont think when it comes to mental health it is related as a community issue. 

 
Elizabeth Bautista
on Feb 10, 2014

The more traditional response is mental health is geared toward individuals. However, using social theraputics as a guide, we can direct mental health toward a community. For example, as a student learning about social theraputics, I use some of what I learned toward how to manage my group to help manage change, to maintain morale, to provide a sense of belonging in a large organization. In this instance, I view mental health not necessarily from an individual standpoint but from a group standpoint where, if I create environments at work that are positive, each individual's mental health will be positive, thus creating a constructive and productive group.

 
Lisa Kimball
on Feb 11, 2014

There is actually a book that speaks to that. It's called the Moral Landscape. The author is exploring how to live a moral life without religion. His point is that we are healthier as a person when we invest in others and seek interest in the well being of others. 

 

 
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Kate Mehler
on Feb 02, 2014 - 11:19 pm

Greeings!  Looking forward to this conversation!

 
Baylah Wolfe
on Feb 02, 2014 - 7:26 pm

From Brookly NY: Future Teachers of America" and B'nai B'rith Girls in high school, Hillel in college, the civil rights movment, "A Library for Greenlawn, NY," Happy Herman free school, A Circle, Yenta's Speaking Out, Developmental Philosophy Group,  the developing Development Community, I have been part of building all these groups groups and more since I was 16. That is where I am with others, that is where I feel alive - creating commumity is where possibilities emerge!

 

Responses(2)

Diane Whitehouse
on Feb 03, 2014

By the way, if this shows up multiple times, I am having an issue posting it... DW

 

Hi Hugh, thank you for your wonderful introduction.  You really put out alot that has sparked many concerns in what's happening in the world.  When I think about living emotionally healthy is I think about not being fooled into into thinking that I won't have emotions.  I get lonely sometimes, I get sad.  I don't go to that something is wrong with me and that I need to get it fixed.  I live as joyfully with the sadness and loneliness as I do with the excitement and joy that I have in my life.  My experience of that during my years of psychotherapy that I needed to get rid of it or take medicine to not feel it.  Social therapy has created for me the tools that can impower me to have it all...

To ask a question.  Is mental health only an "individuals" health? 

 
Esben Wilstrup
on Feb 07, 2014

Wow, that's a lot of projects you have been part of creating, Baylah.

 
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Diane Whitehouse
on Feb 02, 2014 - 6:31 pm

hello, joining from Boston, ma. 

 
Randy Wilson
on Feb 02, 2014 - 10:18 am

Joining in from San Francisco!

 
Andres Marquez-Lara
on Jan 30, 2014 - 12:25 pm

Looking forward to what we will create together. Warmly, Andres

 

Responses(1)

Barbara Silverman
on Feb 03, 2014

This is such an unusual opportunity to create a conversation with our clients and colleagues!

 

 

 
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christine lacerva
on Jan 28, 2014 - 1:59 pm

Really look forward to creating this conversation!

 
Phyllis Goldberg
on Jan 20, 2014 - 4:23 pm

Looking forward to it as well!

Phyllis

 
Hugh Polk
on Jan 20, 2014 - 12:44 pm

I'm also looking forward to this important dialogue--

Hugh

 
jennifer bullock
on Jan 19, 2014 - 4:32 pm

Very much looking forward to this conversation!