urocyon

greenknight pointed out two interesting posts earlier, and I thought I'd pass them both along. One, How to keep someone with you forever, from

issendai, talks about the characteristics of sick systems in both personal relationships and organizations. I couldn't help but be reminded of a couple of pieces casting the federal government (BIA in particular) in the role of abusive partner. Controlling and abusive tactics look pretty similar across the board. :-|

The second is

rachelmanija's response to Robin Hobb/Megan Lindholm's recent article on mental illness and the "artistic temperament", This Is Your Brain On Drugs....

The hell of it is, both made some reasonable points.

I am pretty thoroughly fed up with the "artistic temperament" BS as it gets applied. It's too frequently used to excuse away and cover up very real difficulties people are encountering, without even trying to figure out how to help them get even minimally functional. Yeah, I was on the wrong end of that one (along with general "giftedness") a lot in school--and to some extent at home--to the point that I suspect my EF problems helped get me so firmly labelled as "artsy". That would be marginally OK if it hadn't been to the exclusion of much else in the way of skills being expected. (Situational) depression and dyscalculia*? Hardly even registered. What else would you expect from someone so "artsy"?

OTOH, I was obviously having problems to the point that the school psychologist (whom I'd never even met) insisted that I be put on Ritalin or be removed from school. Until my mother cited exactly how this was illegal. Bear in mind that this was ca. 1982, and I was a girl. I knew several boys (including one of my cousins, living in a bad situation) whose parents believed the school system could mandate medication, and who then got plonked in a special ed classroom more for segregation than, erm, education. AFAIK, nobody in that system even tried to figure out why any of us were having difficulties in the first place, much less made any attempt to work around them. (Yeah, the sick systems thing ties in here.)

Once I hit adolescence, it became more difficult to pretend that I was not having trouble coping, with depression and never-really-addressed LDs, at the very least. On one hand, it still got excused as an "artistic temperament", while on the other I got into the psych system. That did include enforced therapy (under looming threats of hospitalization) as well as medications, but the emphasis was still more on what was wrong with me than on trying to figure out what might help me cope better in my daily life. The day-to-day difficulties with EF and inertia--and never having learned much in the way of organizational skills--did not magically go away under the influence of Prozac and therapy to unearth repressed memories of trauma I did not, in fact, experience. (Based largely on autistic behaviors--such as really not wanting people to touch me unexpectedly, and flinching--and very real Complex PTSD from different sources which were not considered relevant, if discussed at all.) Very little in the way of practical help with coping skills--other than a victim-blaming stint in a social skills group when I admitted to being relentlessly bullied--was offered. I just couldn't do certain things because I was sick, and I'd better get used to that.

This pattern continued and escalated, until I completely burned out and crashed out of college. And got progressively heavier-duty meds, with no recognition that things like a lack of coping skills (much less added emotional abuse, rape, and stalking) might have helped this happen. And I am reminded of one piece, A tale of two boys, by Laurie Ahern, though my crash was rather different-looking. That does seem to rely a bit heavily on a false dichotomy, but there is a very real problem with overreliance on labels and meds in cases like this, often to the point that (competent) talk therapies are neglected.

Some medications may be useful for some people in some circumstances, but as a tool rather than some kind of magical fix. And assuming informed consent and lack of coercion**, which is one of my objections to medicating kids outside very extreme circumstances. It's still important to recognize the power imbalances involved, even if you really do think it's for the other person's own good. And balance the potential for decreasing the person's distress against the very real possibility of cognitive (and other) side effects. And pay attention if they report adverse effects, instead of just chalking it up to "resistance". And so on.

The most important thing, IMO? Recognizing that the person is running into problems, and working with them to try to figure out what will help them cope better, in a non-judgmental manner. (This may well include medication(s), BTW.) There is no magical fix, and it really doesn't help to frame the situation in terms of fixing someone else. If what you are doing is not improving the situation, it's time to reconsider how (and why) you are "helping"--and try a different approach to working with the person until you find something that does work.

The biggest overall problem, AFAICT? Universalism, to the exclusion of pragmatic approaches to helping people lead better lives (where "better" is whatever makes that particular person happier and healthier). As I described it elsewhere:

The source of the difference--neurodiversity or culture--doesn't even matter, from a universalist standpoint:
Here’s what I mean: if I have a universalist orientation, that fact alone can make me insensitive to cultural difference. If I’m universalist, I will tend to believe there’s one set of principles to live by — everywhere in the world. That is a stance that undermines what intercultural sensitivity is all about.

This shows up all over the world when universalists are present. Think of imperialism and colonialism: it’s no accident that the main perpetrators have been nations with largely universalist orientations.

Universalists can be slow to see a need for intercultural consulting, coaching and training. What value could these services possibly add, if things are the same the world over? Or, in a weaker version: if everyone in the world wants the same things?

If everyone is assumed to be perceiving things in the same way, reacting to them in the same manner, expressing the resulting (same) emotions in the same way, while motivated by the same considerations in any given situation--any deviation from the expected pattern may well be interpreted as a sign of poor mental health. This has happened to me, and to family and friends.

Especially in the US these days, the response to a perception of mental illness is frequently to medicate the person, without really trying to find out what is going on. Nor what coping skills and/or support might help them live the kinds of lives they want. Situational distress is sometimes assumed to be a lifelong, biologically-based mental illness, though the symptoms may go away when the person's stressful circumstances change and/or they learn some better ways of coping with what's going on in their lives. (Of course, people who really do fit criteria for mental illnesses also benefit greatly from this!) A medicalized, universalist approach to human diversity seems to be what Robin Hobb/Megan Lindholm is protesting--and taking it way too far in another display of insulting universalism.

Everyone is different. Every situation is different. It's important to bear this in mind. The "oh, that's just how s/he is" approach, while very useful up to a point, can be taken to the point of the absurd (as in common usage of the "artistic temperament" idea). When has it gone too far? When you are more interested in cramming someone else into the "artistic temperament" (or similar) model than in paying attention to what very difficulties the real human being in front of you may be experiencing. If you can't do things like make sure your bills are paid on time, that's a problem, right there--and it can be worked around and/or some kind of support put in place.*** It's just the flip side of the "you can't do X and Y because you're mentally ill" coin. Binary, universalist thinking trumps actually helping the person, in either case. It's dishonest and disrespectful, besides just not being useful.

Which brings me right back around to the themes of balance and pragmatism, honesty and respect, and pretty much all the rest of the stuff I talked about in Happiness, Part 4: Seeing beauty. What has helped me the most is working on figuring out what I really want and how my brain works, doing away with a lot of the universalist "shoulds"--and working with that to find strategies that help me do what I want/need to do.

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* Some of the other autism-related stuff was just evidence that I was lazy and uninterested, the classic bored underachiever. (It couldn't have been that I was overloaded, overwhelmed, and on the verge of shutdown or meltdown most of the time in that environment.) Which could also be expected under the circumstances. :-|

** Be it of the "you will swallow this in front of me or go straight to the hospital", "this is your only option, if you want to have any kind of decent life and show an iota of consideration for yourself and other people", or "your questioning the treatment plan I have laid out is a sign that you are very ill indeed and lacking insight" varieties. Yes, I have personally encountered all of these, and more. (While mostly just depressed.) And none of it is right.

*** I have enough other things to try to deal with that it's sooo much better if someone else (or automated online payment setups, if possible) can handle certain tasks. Note that there is a huge difference between recognizing that this takes a lot of different kinds of spoons which could be better used for other essential tasks, and the abusive twins "oh, she's just artsy" and "it's laziness/craziness/stupidity, pure and simple".