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A Newer Narrative-- Mental Health and Wellness


amuse.ed

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Its World Suicide Prevention Day on the 10 Sept 2022 and World Mental Health Day on the 10 Oct 2022. As a person with a diagnosed mental health condition since 2001, I firmly believe that what takes place in our head (thoughts), heart (feelings/emotions) and hands (behaviors) are interrelated. From today onwards, contents will be curated periodically, hopefully to:-

 

1) Create more awareness on mental health and wellness (especially non-mainstream ones)

2) Affirm individuals who may find the content resonated with them 

3) Build a robust well-informed community on mental health and wellness

 

* Chinese subtitles only

Credit: Book Intro: Madness: A Brief History by Roy Porter 超級歪 SuperY  Oct 17, 2018

 

 

Podcast content in English with subtitles: Andrew Scull—Desperate Remedies: Psychiatry’s Turbulent Quest to Cure Mental Illness, Mad in America, Jul 13, 2022

 

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I find it so sad that psychiatry and related neurology, biology have so completely failed to become a benefit to society, instead wasting so much human life and incurring in huge costs. 

 

I believe in the body - mind connection,  " mens sana in corpore sano ",  like the ancient Greek philosopher proclaimed.   If I had any influence on a person with a severe mental health condition, like madness,  I would divert attention from the mental problem/s  ( if possible ) and put the effort on improving health and fitness to the highest level.  In addition, I would seek a counselor who could see if there is a logical, rational explanation of the condition which could have a solution of attitude change.

 

As a very young man I spent some time on the couch of a professional "psycho-analyst", who dug into my brain with much silence, and although I got some distraction from my problems, which had to do with being gay, there was no solution at all.  I would have been helped by any person, regardless of degrees, who would have understood my situation and modified my attitude.  I think a gay forum like BW would have helped!

.

Edited by Steve5380
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I believe I'm mentally ill.

But I also believe there is no cure. 

 

For e.g

I believe those who queue up to go JB on 2 Sept and wait there for 7 hours are mentally ill. 

I once was stuck in cny custom and it wook 8 hours. 

I was traumatised that I swear I will not cross custom on holiday / festival. 

 

I will only cross on Wednesday when ppl already come back to work. 

During exam period.. 

And made sure there is no holiday in both jb and Singapore. 

Otherwise you make me go I also won't!

I rather have no holiday than spend 7 hours at the custom. 

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Guest Congratulation
On 9/5/2022 at 12:04 PM, Guest Scared said:

I believe I'm mentally ill.

But I also believe there is no cure. 

 

For e.g

I believe those who queue up to go JB on 2 Sept and wait there for 7 hours are mentally ill. 

I once was stuck in cny custom and it wook 8 hours. 

I was traumatised that I swear I will not cross custom on holiday / festival. 

 

I will only cross on Wednesday when ppl already come back to work. 

During exam period.. 

And made sure there is no holiday in both jb and Singapore. 

Otherwise you make me go I also won't!

I rather have no holiday than spend 7 hours at the custom. 

Based on your 1st sentence, you’re Not mentally ill.
Usually, those with mental illness would not know and admit it.

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On 9/4/2022 at 11:04 PM, Guest Scared said:

I believe I'm mentally ill.

But I also believe there is no cure. 

 

For e.g

I believe those who queue up to go JB on 2 Sept and wait there for 7 hours are mentally ill. 

I once was stuck in cny custom and it wook 8 hours. 

I was traumatised that I swear I will not cross custom on holiday / festival. 

 

I will only cross on Wednesday when ppl already come back to work. 

During exam period.. 

And made sure there is no holiday in both jb and Singapore. 

Otherwise you make me go I also won't!

I rather have no holiday than spend 7 hours at the custom. 

 

I can believe the same in your e.g.,  yet I am not mentally ill.  I also believe that those who pile up at US airports and get stuck in US highways because they MUST take vacation on the 3 day Labor Day holyday are mentally ill   spoiled idiots who are completely ignorant about what is valuable in life.

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I watched yesterday in the program " 60 minutes " an episode about mental illness in the young. 

 

 

 

Maybe one day in an advanced society, religion will be replaced with a  Life Philosophy.  Something taught from infancy that opens the eyes of the young to the realities of being a living creature.  

 

This will start with the reality that we are members of the Animal Kingdom, with a basic explanation of the works of our body and mind that will reveal what fantastic creatures we are,  infinitely more complex and superior to any man-made machine ever produced.  So that instead of marveling about a fantasy God, the young will start marveling at the divine creature THEY ARE.

 

It will be taught that the majority of the Animal Kingdom lives in a perpetual state of SURVIVAL ( of the fittest ).  Most animal minds are perpetually occupied with how to get food and how to avoid being killed,  with some occasional distractions mating and reproducing. The young will realize that we humans are a sole exception, how different our lives are from the rest of the Animal Kingdom,  and so they are motivated to feel blessed.  

 

Instead, today's education of the poor American youth is totally different.  They learn to take everything positive they have, which is tremendous,  as granted, and with most of their necessities satisfied their minds are left idle to build up their wishes and then agonize over what they don't have.  They will seek ways to indulge in acts that will alleviate their agony, in their complete ignorance that their fantastic body must be cared for to prevent decay and illness. 

 

Take for example the girls that appear at 3:19.  They look perfectly normal. They are pretty, and they may not have any parts of her body missing, any disabilities.  BUT...   during the pandemic they were confined and had noting to do,  separated from their friends, etc.   SHOULD THIS LEAD TO MENTAL ILLNESS?  They must live with a family, in a household full of necessities.  Nothing to do? there are needs to cook, wash the dishes, clean the bathrooms, swipe the floor, wash the clothes, iron them, etc.   They must have the Internet, full of entertainments.  How incredibly spoiled these children are that they must have a MENTAL ILLNESS?  They say they lost... THEMSELVES!  What an absurdity!  How much idle, spoiled time must persons have to " lose themselves "?  

 

I am not criticizing this youth.  It is NOT their fault!  I am not foreign to their situation.  As a late teenager I once decided to commit suicide.  I was thinking of electrocution (expert in electricity, electronics, ha ha).  I was saved by my blessed mother.  Not by herself directly, since at that time I was living alone,  but by her loving indoctrination of telling me how gifted, how special I am!  ( this is the best brain-washing parents can do ).  So I could not get myself into destroying the valuable specimen I thought I was.!

 

So much "mental illness" is precipitated by the wrong mental attitude,  crass ignorance of life, absolute lack of the right experience!!  Instead of doctors with degrees in psychiatry and tons of drugs,  what would have the biggest positive effect would be proper education. 

 

There is a new thread here: "what jobs won't exist in 10 - 20 years?"  Possibly many manual and blue collar jobs may disappear due to automation.  But one gain may come out of this:   more jobs of counselors and educators that can teach our children from the youngest ages that what is important, so that they acquire plenty of MENTAL HEALTH.

.
  

Edited by Steve5380
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At the end of the day, finding like-minded people who shared similar commonalities are getting tougher even amongst the communities. I did like to subscribe the five pillars of mental health conditions recovery which includes:

 

1) Biological 

2) Psychological

3) Social 

4) Spiritual  

5) Sensual (Sexual)

 

The first four is common but the fifth one is least spoken about, with the increasing number of sexual related offences happening, perhaps its time to be more open about things and talk about sex regularly? 

 

Debating 'Anti-Psychiatry' Advocacy, Jul 14, 2020  What is the “anti-psychiatry” movement? In today’s Not Crazy 

 

Edited by amuse.ed
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  • 2 weeks later...

May or may not work for some people. Can try nonetheless.  Credit: Youtuber, Daniel Mackler

 

Self-Therapy & Healing Childhood Trauma (1 of 3)

 

 

 

Self-Therapy & Healing Childhood Trauma (2 of 3)herapy & Healing Childhood Trauma (2 of 3)

 

Self-Therapy & Healing Childhood Trauma (3 of 3)

 

 

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On 9/18/2022 at 11:27 PM, amuse.ed said:

May or may not work for some people. Can try nonetheless.  Credit: Youtuber, Daniel Mackler

 

Self-Therapy & Healing Childhood Trauma (1 of 3)

 

Self-Therapy & Healing Childhood Trauma (2 of 3)herapy & Healing Childhood Trauma (2 of 3)

 

Self-Therapy & Healing Childhood Trauma (3 of 3)

 

 

 

I like these videos of Daniel Mackler too.   And I am a believer in self-therapy.   We can reach in our spirit to where not even the best external therapists can do.  We need to trust ourselves and be diligent trying to fix ourselves.

 

I like the idea exposed in the first video about writing a diary.   Today it is not necessary to make a hole in the volume and put a lock on it to keep other eyes from reading it.  Today we have the computer, we can write text with a keyboard,  and we can protect our diary file by keeping it in an encoded volume with a password.  I still use this old program TrueCrypt  for this, although there are more recent programs.

 

It has never occurred to me to write a diary,  but I have a huge "miscellaneous" text file with dated entries added at the top,  which covers the last 23 years with all sorts of topics, from personal, financial data,  events, names, everything.  The benefit of such a file is that it is SEARCHABLE,  so if I want to know what brand of motherboard I bought for my PC 15 years ago and how much I paid,  all I have to do is search "motherboard".   So maybe I should start also a diary,  with my personal intimate feelings,  so I can search for "horny",  "sex in Singapore",  "Rejections", "boyfriends",  etc. 

 

Now,  seriously...   I agree that most of us were damaged as children by parents who didn't understand what we were going through.  But nobody is to be blamed,  because we humans are not mind readers.  And maybe our subconscious is filled with early experiences of a society that did not understand us.  This is something we can clean out now by ourselves, if we take the task.

 

 

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On 9/21/2022 at 8:37 PM, amuse.ed said:

Content shared can be controversial. Kindly watch it with an open mind and open heart. Personally feel the concepts shared has its worth to sustain one's mental wellness in this chaotic world.

 

 

Thank you for making me aware of the philosophy of Friedrich Nietzsche.  I had heard of him of course, but never paid him any attention.  

 

What I now discover is that I am thinking all my life close to what he thought.   I should start reading more about him.

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Everyone (read my lips), at some point in life will have to face mental health issues.  Nobody is spared. 

 

The underlying problem is that while some people struggle to escape it, others made every effort to do it without the aid of a professional.
The greatest answer, in my opinion, is to stop your mind from dreaming, overthinking, remembering, and envisioning things that might not actually occur or, if they did, might not be as horrible as you had imagined. Unless you hurled yourself into the lion's jaws believing that is the only way to tackle fear and worry, no lion is going to suddenly emerge in front of you and maw you to death, regardless of how bad your life is.

 

 

 

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On 9/25/2022 at 9:19 PM, Guest Roar!!! said:

Everyone (read my lips), at some point in life will have to face mental health issues.  Nobody is spared. 

 

The underlying problem is that while some people struggle to escape it, others made every effort to do it without the aid of a professional.
The greatest answer, in my opinion, is to stop your mind from dreaming, overthinking, remembering, and envisioning things that might not actually occur or, if they did, might not be as horrible as you had imagined. Unless you hurled yourself into the lion's jaws believing that is the only way to tackle fear and worry, no lion is going to suddenly emerge in front of you and maw you to death, regardless of how bad your life is.

 

 

Your lips are right.  We will have mental issues like everyone will have to face physical health issues.  

 

While not all the conventional medicine practiced by doctors may be beneficial to the body,  the effectiveness of the conventional "mental medicine" practiced by the mental professionals is much, much less trustworthy.  And this makes sense.

 

While the medical establishment uses microscopes,  biochemistry, reagents, scanning tools, and much of applied physics and chemistry to learn about the physical body and find treatments,  no mental professional can read the mind of the patient,  and at most he can try to find some loose relationships between 'mental' and 'biochemical', and prescribe some drugs, followed by some observations that are detached from any responsibilities.

 

What we as individuals can do is try to look outside our selves,  try to see things in proportion, avoid seeing little kitten as lions, and personal tragedies as victimizations of a Holocaust,  and recover some peace of mind while we become avid seekers of knowledge.   Knowledge of how to self-heal, how to change our perspectives,  how to moderate our preoccupations and suffering, and enhance satisfaction and happiness.  

.

Edited by Steve5380
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Mental Health Conditions (MHC)

 

Is MHC really a struggle?

Why is it not seen as a challenge?

Life milestones that need to be surmount

Necessary evils for public at large

 

The experts said that it could be in the genes

which are inhabited in their bodies

Others said it is one's character and personalities 

something that is of a psychological mean

 

How about factors of the extrinsic

The environment one is immersed in

Social is what it is or perhaps Spiritual too

And how about Sexual or Sensual

Something no one wish to talk it publicly?

 

Seems like the Gen Millennials, Z, Alpha 

are ready to talk about all these

How about the Gen Silent, Baby Boomers and the Xs?

Why do they choose to be hush hush about it?

Maybe there is a gap- a space between response and stimulus

 

Again, no one wish to be related to a weakness

That the society often associate MHC with 

Is MHC really a weakness?

Or is it a challenge that builds one's resilience and tenacities?

 

Perhaps those who choose to be hideous are " xxxxxx "

People who are not ready and willing to face their challenges

Building their lives full of false life resilience and tenacities

Or are they living in denial, living at their own ivory towers?

Or they just choose to be least vulnerable?

 

Definitely not coercing anyone to see a shrink to get a diagnosis  

It is important to know that stresses are real 

Stresses that can affect one's mental and emotional well-being

And hence people of their surroundings

Kindly take MHC seriously 

 

Because completing suicide is not the next thing

One's loved ones wish to see

So please consider very carefully.....

Because an open mind and heart are very much needed 

To start off the conversation on mental health and wellness

 

ET

30.09.2022

 

Inspired: https://thewokesalaryman.com/2022/09/20/but-my-generation-had-it-worse/  

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On 9/29/2022 at 11:59 PM, amuse.ed said:

 

I like this conveying truths with comics.   I have learned the mistake of the old and the young in thinking that the past was better.    I think that I am having a much, much better life than my parents,  and I see with satisfaction that my son has it better than I have,  and that my grandchildren are being educated by a loving father, which will make their chances of having happy lives much better.  :) 

 

Of course I cannot read the mind of anyone,  so I cannot be sure that their lives are better or worse, so I accept that their lives are just different, facing the same existential issues.  

 

 

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Credit: Depression because of not being happy enough? No, it's the brain that's really sick - "Emotions are not what you think", https://pansci.asia/archives/184983 Loosing translated via Google. 

*** The word budget in the article can be replaced by calculated instead. 

 

For many scientists and physicians, depression remains a mental illness. It's classified as an emotional disorder and is usually blamed on negative thinking: you're too hard on yourself, or have too many self-defeating, catastrophic thoughts. Or maybe a traumatic event triggers the blues, especially if your genes make you vulnerable. 1

 

Or you may not regulate your emotions well enough that you are too reactive to negative events and too unresponsive to positive events. All explanations assume that thinking controls feeling, the old "triple-brain" idea. Logically, just change your thinking or regulate your emotions, and the blues will go away. The mantra seemed to be "Don't worry, be happy; if it doesn't help, try an antidepressant."

 

The brain and body act as if nothing happened, but they are swallowed up by emotions. More than 70% of the 27 million people in the United States take daily antidepressants, yet continue to experience depressive symptoms, and psychotherapy isn't effective for everyone. Symptoms usually begin during adolescence through early adulthood and then recur throughout life.

 

The World Health Organization estimates that by 2030, depression will cause more premature deaths and disability than cancer, stroke, heart disease, war or accidents. 2 These are the horrific consequences of "psychological" illness.

 

Many studies have attempted to find the universal genetic or neurological nature of depression. But most likely, depression isn't just a single thing. 3

Melancholy (as you should have guessed) is a concept. It is a diverse group of instances, so there are many regressive paths to depression, many of which begin with an unbalanced body budget. If depression is an emotional disorder, and emotions are an integrated summary of how well your body is budgeting (answer: very bad), then depression may actually be a disorder of budgeting and forecasting.

 

We know that your brain is constantly predicting your body's energy needs based on past experience. Under normal circumstances, your brain also revises its predictions based on actual sensory information from your body. But what if such corrections do not work properly? Your momentary experience is constructed from the past, not revised by the present. In a nutshell, this is what I think happens when you're blue. 

 

As a result, your brain and body behave as if you were in peace, struggling to fight off infection or heal from injury, just like chronic stress and pain. As a result, something goes wrong emotionally: you experience debilitating misery, exhaustion, or other symptoms of depression.

 

At the same time, your body rapidly metabolizes unnecessary glucose to meet those high but non-existent energy needs, causing weight problems and making you more likely to develop other metabolic-related disorders that accompany depression, including diabetes, heart disease and cancer. 4

 

How you feel at the moment, as a prediction drives your next thought and your perception. So the melancholic brain makes predictions based on similar extractions from the past, ruthlessly continually extracting from the budget. It means going through difficult, unpleasant events again and again over and over again. You end up in a cycle of budget imbalances that cannot be broken because forecast errors are ignored, downgraded, or not entered into the brain. A depressed brain effectively plunges itself into misery. It ignores mispredictions like the chronic pain brain, but stops you functioning on a larger scale. It keeps your budget in debt for a long time, so your brain tries to cut back on spending. What is the most efficient way? Stop moving and don't focus on the world (misprediction). This is the inexorable fatigue of depression. 5

 

If depression is the result of chronic budgeting errors, it's technically not just a mental illness, it's a neurological, metabolic, and immune disorder. Depression is the loss of balance of many intertwined parts of the nervous system, and we can only truly understand it by looking at the whole person, not a single system like machine parts. The tipping point of a major depression can come from many different sources.

 

You may be chronically stressed or abused, especially in childhood, leaving you with a model of the world built from harmful past experiences. You may have a physical condition like chronic heart disease or insomnia, leading to poor guilt predictions. Your genes may make you sensitive to your environment and every little problem.

Additionally, if you are a woman of reproductive age, the interconnectedness of the interoceptive network changes over time throughout the month, making you more susceptible to unpleasant emotions, rumination, and possibly even higher risk at certain points in your cycle Suffering from emotional disorders, such as depression and post-traumatic stress disorder. 6 

 

Thinking positively or taking antidepressants may not be enough to bring your body budget back into balance, and other lifestyle changes or system adjustments may have to be added. When antidepressants and cognitive-behavioral therapy kick in to make you feel less depressive, activity in key body budgeting areas returns to normal levels, as does interoceptive network connectivity.

 

These changes are in line with the idea of reducing over-prediction. We can also use more prediction errors to treat depression, for example, asking him to write down his positive experiences every day, which can reduce the burden on the body budget. The problem, of course, is that no single treatment works for everyone, and some people just can't find one that works. 7 

 

One of the most promising avenues of treatment I have ever seen is Helen. Marburg's seminal research (Chapter 4), in which she stimulated the brains of patients with treatment-resistant depression with electrical currents. Her technique immediately relieves the excruciating pain of depression, but only when the current is turned on, when the patient's brain switches from its exhausting inner focus to the outer world, so the brain can normally predict and process mispredictions. 

It is hoped that these preliminary but encouraging results will eventually lead scientists to develop more durable and effective treatments for depression. At the very least, these results should help make it clear that depression is a disease of the brain, not just a lack of happy thoughts .

 

 

Notes:
'a disease of the mind': To compare which diseases are 'neurological' or 'psychic', a neuroscientist and blogger, anonymously identified as a neuroskeptic (Neuroskeptic 2011), counted by topic from 1990 to 1990. Number of academic papers published in Neurology and the American Journal of Psychiatry during 2011. See also heap.info/neurology-1. "your genes make you vulnerable": Certain genes make you more or less sensitive to the environment (Ellis & Boyce 2008). See Akil 2015 for extensive lecture content. See also heap.info/depression-1.

 


“Not effective for everyone either”: Olfson & Marcus 2009; Kirsch 2010. See also heap.info/depression-5. "and then recur throughout life": Curry et al. 2011. "War or Accident": Mathers et al. 2008.
"is not just one thing": This is true because most human phenomena and traits are caused by degenerate genetic combinations, even though their genetic quotients are high, the combinations are variable to It is unlikely that there is a detailed genetic explanation for either (involving the exact genes and mechanisms by which they affect each other), meaning that the observed changes from that trait are mostly due to genetic variability (Turkheimer et al. 2014).

 


"Sensory information from your body": For example, your muscles contain energy sensors that send feedback about energy usage back to your brain (Craig 2015). "or other symptoms of depression": Barrett & Simmons 2015. "heart disease, and cancer": Your metabolism controls your immune system to some extent; fat cells secrete pro-inflammatory cytokines (Mathis & Shoelson 2011), meaning obesity exacerbates chronic inflammation . See, for example, Spyridaki et al. 2014.
“scale that shuts you down”: Kaiser et al. 2015. When exploring the brains of people with depression, we found changes in activity and connectivity that fit this hypothesis, see heap.info/depression-2.
'the parts of a machine': In melancholia, the disorders are quite widespread, see heap.info/depression-3. “built from toxic past experience”: Ganzel et al. 2010; Dannlowski et al. 2010. Once the glucocorticoid gene (in rats) is overexpressed in childhood, brain pathways become fixed, leading to lifetime vulnerability to affective disorders and more instability, even when these genes are turned off in adulthood (Wei et al. . 2012). Harmful past experiences can also lead to persistent inflammation in childhood, increasing the risk of depression or other illnesses later in life (Khandaker et al. 2014).

 

"environment and every little problem": Sometimes called "neurotic" or "affective reactivity", see also heap.info/depression-1. Post-traumatic stress disorder: Risk is greatest when levels of the ovarian hormone progesterone are high. This may help to explain why the proportion of women with affective disorders is much higher than that of men (Lokuge et al. 2011; Soni et al. 2013), eg Bryant et al. 2011. See also heap.info/women-1.
"Your interoceptive network is restored": that is, there is less activity in the anterior cingulate cortex below the knee, and its connectivity to the rest of the interoceptive network is increased, with the thalamus (carrying the (Riva-Posse et al. 2014; Seminowicz et al. 2004; Mayberg 2009; Goldapple et al. 2004; Nobler et al. 2001). For a review of meta-analysis, see Fu et al. 2013. “For whom no treatments work”: MaGrath et al. 2014.

 

Edited by amuse.ed
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Released On: 23 Feb 2021

 

"Available for over a year
For a long time people who heard voices or suffered paranoid delusions were thought to be too crazy to benefit from talking therapies. As a young man working on a prison psychiatric ward, Richard Bentall thought otherwise. Together with a small group of clinical psychologists, he pioneered the use of the talking therapy CBT for psychosis and conducted rigorous randomized controlled trials to find out if and why it worked. Turns out, having a good relationship with your the therapist is at the heart of why therapy succeeds, regardless of the type of therapy practised.

Richard talks to Jim Al-Khalili about his quest to understand psychosis and how his own mental health has suffered at times. He's interested in how adverse life events affect our mental health and has shown that people who suffer abuse, bullying and victimization as children are three times more likely to have a psychotic episode later in life. A large survey of our mental health, launched by Richard and colleagues on day one of the first lockdown has revealed that lockdown and Covid-19 has not led to a tsunami of mental illness that many feared. 10% of the population has seen their mental health improve."

 

https://www.bbc.co.uk/sounds/play/m000sj7c

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A good summary of Nietzche philosophy and its lifestyle application (2021). Imho it resonates and closer to I-ching for better mental wellness and health, especially one is HSP and INFJ/P

 

1. Solitude vs Lonliness

2. Mind your own business 

3. Follow your own goal

4. Choose reality over religion 

5. Follow your intuition 

6. Use envy to your advantage 

7. Find happiness in little things (I prefer peace though)

 

 

Edited by amuse.ed
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Equilibrium?

 

I am still trying to find an equilibrium 

Making sense what constitutes episodes of mental illnesses

Not going to either extremes 

Trying to find a middle placing 

 

A position that seems least enticing 

Perhaps that's when Tao will comes in handy

A few philosophers I have listen and read 

Some make sense, some torn me into pieces 

Others left me feeling amused

 

Guess I will take things as its stride

As I navagiates this heighten awareness amidst of the other plights

Will there ever be a middle ground? 

I recalled someone once said... its either one is hot or cold for something

If not, off you go and be ambonished 

 

A dangerous ground to thread 

A familiar ideology to adhere with 

Or can one simply just run away 

And even abandon the plan...

the plan that murks with the rest?

 

ET

29.10.2022

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**Disclaimer: Please listen to the following content at your own discretion. Seek trained professional advice if in doubts. For individuals who wish to discontinue their psychotropic medications, kindly consult your Psychiatrist first before doing so. 

 

**Turn on CC for Engish subtitles

 

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  • 2 weeks later...

Having been in the mental health and wellenss space for more than two decades, what were addressed in this content was nothing new really. Spore is still running in cycles with regards to mental health and wellness despite time, energy and efforts being invested. That goes to show similar concerns presented 20yrs aren't adequately addressed.

 

What lacking imho is.... walk the talk something that needs to be done asap. 

 

 

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  • 2 weeks later...

 

Turn on CC for English subtitles. Credit: Ian Smith, YouTube 

 

 

I'm with her 

 

Written by Jo Watson
Eleanor Longden audio courtesy of: 
ted.com/talks/eleanor_longden_the_voices_in_my_head


Like - 'not on the fence ' ‘cause surely our mental health IS  linked to experience so often a direct consequence of trauma, of oppression & I don’t know about you but i’m getting the impression that we've been being tricked Like - really  - good and proper Into feeling , believing that the these problems tell us -about Us-    About who WE ARE  rather than what it was that actually carved the scar

 

You see ...we're FOOLED into thinking its about biology physiology & intrinsic to identity They tell us that  'its in our genes' instead of being in the scenes of what happened to us that play out on repeat sometimes You know .. the ones we don't mention too much Our Great grandmothers

 

Look - some of our GREAT grandmothers were incarcerated, locked away, for years and years Left to decay sometimes shackled in metal vices whilst SLICES of their brains were cut out to ‘exorcise' the threat & yes this meant that sometimes they would forget the horrors but it also meant that sometimes they would forget their names Our Grandmothers I guess it won't come as a big surprise that large numbers of our grandmothers were tranquillised, pretty much sedated & this equated to a kind of 'half life' often for their entire life. & when this didn't quite sort them out 'make them sane' they may well have been strapped down whilst electricity was shot into their brain & Our Mothers lots of our mothers were flooded with old school anti-depressants & mass unnecessary womb extractions     and  reactions to instant hormones which for some- meant a detour   around that mid-life rite of passage that may have brought them home. And as for us  - well, we are labelled and medicated disorders allocated often accumulated ‘cause there's no shortage of diagnostic criteria to explain any deliria, or otherwise honestly - you’d be surprised there's a disorder for everyone It's true There's a disorder for everyone

 

WHAT  -YOU haven't been diagnosed yet? ‘cause I promise - there -IS a disorder for everyone They're in the book   (the dsm5) the place from where they all derive Hundreds of  them All squashed in All planned   as supply and demand doesn't work too well without the demand bit so our 'disorder' has to fit we need the pills to cure it cure us ,  be our defence chemical compounds of modern science that conveniently turn off or tone down our emotions Our feelings & I understand I'm ranting now but - here's the thing ... Subtly….hidden away underneath the 'anti stigma' shiny surfaced campaigns of the day of 'mental health awareness raising' that are so good at glazing over the point - over the pain

 

We find more of the same Hidden away is more of the same excuse the pun but this is sending me insane ‘cause now even the good ones are having a try, you know - the likes of Ruby Wax & good old Stephen Fry sadly still perpetuating all the toxic lies & generally doing a great job of using celebrity status to pathologise So we all get to believing that's it IS about us "mental health is like physical health!"  ... and alongside that-    (invariably) a belief that it's part of identity so part of me - the heart of ME that isn't going away  it's here to stay needs to be managed, contained, needs to be chemically explained?! So we really need a 'rethink' And it's defiantly 'time to change'  

 

Because as otherwise precisely nothing is being rearranged and we’ll just see a continuation of the same old, same old shit convenient disempowering medical-model-rhetoric Cos TRAUMA  can't be relevant It's too much of a threat TO the general scheme of things Instead we should forget Forget ..About what's happened , and put it down to genes to 'chemical chaos ' 'predispositions ' & The biological machine You know.. Eleanor longden - she wasn't EVER asked about what had happened to her They just said she had an illness a kind of broken brain And that this explained the voices And the corresponding pain   So ..'diagnosed' with schizophrenia   & written off  as hopeless case , & yes u may be thinking this is an 'absolute disgrace ' But it isn't an exception it happens every day and its time to change the script now and find another way.

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  • 3 weeks later...

I am thankful to have overcame most of my challenges faced in 2022.

 

Its now 2023 and there will be more challenges up ahead in many fronts. As we know by now, there are no cookie cutters or SOPs to maintain and/or improve mental health and wellness, the most we can do is to find like-minded people for support. What if one is mostly alone and prefer solitude? Perhaps the newer narrative of mental health is to be in solitude or has it always been the case? 

 

Have a better and healthier holistic health, everyone! :0) 

 

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  • 2 weeks later...

** The following article consisted content on suicide. Kindly read at your own discretion.

 

Parents seeking $3.3m from psychiatrist and IMH over son's suicide
JANUARY 13, 2023
PUBLISHED AT 11:58 AM
By SELINA LUM

 

SINGAPORE – In a lawsuit seeking an estimated $3.3 million in damages, the parents of a 31-year-old man who took his own life have accused two psychiatrists of being negligent in treating their son, which they say led to his suicide.

 

Mr Steven Joseph Arokiasamy, 67, and Madam Tan Kin Tee, 66, are suing Dr Nelson Lee, a psychiatrist in private practice, and the Institute of Mental Health (IMH) for the actions of its senior consultant, Dr Gomathinayagam Kandasami.

 

Their older son, Mr Salvin Foster Steven, who had a long and complex psychiatric history, fell to his death from his bedroom window on Sept 7, 2017.

 

They alleged that Dr Lee failed to diagnose their son with schizophrenia, and that both doctors wrongfully prescribed Concerta, a drug used to treat attention deficit hyperactivity disorder (ADHD), to him at inappropriate doses.

 

They accused the two doctors of failing to prescribe adequate doses of anti-psychotic medication to Mr Salvin.

They also blamed Dr Kandasami for failing to admit Mr Salvin for observation on Sept 6, 2017 – a day before his suicide – after they took their son, who had been acting erratically in recent weeks, to see the psychiatrist.


Mr Steven and Madam Tan, who are separately represented by Mr V. K. Rai and Mr Anil Balchandani, contended that as a result of Mr Salvin's death, they both suffered from persistent complex bereavement disorder and could no longer work. Thus, Madam Tan, who left her job as a school counsellor in 2019, and Mr Steven, who left his job in the civil service in 2020, suffered a reduction in income.

The suit was heard in the High Court on Thursday. The trial has been adjourned to September.

 

Dr Lee, who practises at The Psychological Wellness Centre, treated Mr Salvin between November 2011 and July 2016. He diagnosed Mr Salvin with bipolar disorder and ADHD, and prescribed Concerta from April 2012.

Mr Steven and Madam Tan said their son developed a dependence on the drug, but Dr Lee continued to prescribe Concerta and did not advise Mr Salvin against taking more than the prescribed dose.

 

They said Mr Salvin began showing symptoms of psychosis, such as hearing voices or believing that people were plotting against him.

In May 2015, after being charged with the assault of two police officers, Mr Salvin was remanded at IMH and diagnosed with paranoid schizophrenia.

 

He was returned to Dr Lee's care in June 2015. Mr Steven and Madam Tan alleged that, despite being provided with the diagnosis, Dr Lee continued to prescribe Concerta to Mr Salvin and did nothing to prevent him from overdosing.

 

Dr Kandasami took over Mr Salvin's care in August 2016, after he was sentenced to a one-year mandatory treatment order for the assault. The couple alleged that Dr Kandasami did nothing to prevent Mr Salvin from overdosing on Concerta and ignored his psychotic symptoms.

Dr Lee, who is represented by Mr Jansen Aw, said his diagnosis of ADHD and bipolar disorder was reasonable in the light of the symptoms and medical history.

 

There was a lack of overt and persistent psychotic symptoms supporting a diagnosis of schizophrenia, he said.

Dr Lee said Mr Salvin showed improvements when he was on Concerta and, for the first time in many years, managed to get a job in a warehouse in July 2015.

IMH, which is represented by Senior Counsel Kuah Boon Theng, said Dr Kandasami's care and treatment of Mr Salvin was appropriate. Mr Salvin's response to medication was closely monitored during his mandatory treatment, and he did not show signs of psychosis, it said.

IMH said there were no red flags of imminent risk of suicide on Sept 6, 2017.

 

It disagreed with the couple's assertion that Mr Salvin's death was caused by psychosis, noting that the coroner had found his fall to be a "deliberate act of suicide".

 

"The plaintiffs are understandably devastated, and IMH empathises with them for their loss. However, the deceased's unfortunate demise was not the result of any negligence on the part of IMH and its doctors or staff," said Ms Kuah in her opening statement.

 

SINGAPORE HELPLINES
Samaritans of Singapore: 1800-221-4444
Singapore Association for Mental Health: 1800-283-7019
Care Corner Counselling Centre (Mandarin): 1800-353-5800
Institute of Mental Health's Mental Health Helpline: 6389-2222
Silver Ribbon: 6386-1928

 

https://www.asiaone.com/singapore/parents-seeking-33m-psychiatrist-and-imh-over-sons-suicide

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  • 1 month later...

Been witnessing many initiatives, products and services stemmed from the mainstream mental health spaces over these past eight years and leaves one wonder are they running around like a headless chicken or are they genuinely addressing the roots of one's challenges?

 

When can the new narratives of mental health and wellness be rewritten? Perhaps after the abolishment of DSM and ICD?

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9 hours ago, radiusulnar said:

why does abolishing DSM and ICD help?

 

Perhaps one choose not to understand "it's repertoire" well enough?

 

Anyway just like the concepts of justice and equality, it is just an aspiration to pursue but will never ever come true.  Have a better mental health week ahead!

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  • 3 weeks later...

A meaningful article.

 

credit: https://www.psychologytoday.com/intl/blog/4000-mondays/202303/embracing-the-dark-side-of-life

 

"We don’t need to experience the depths of despair to gain access to well-being, but adopting the perspective that adversity is required for a full, rich life of meaning, can motivate us to reflect on death in a way that lets us tune into the upside of the dark side. The practice of memento mori (remembering we must die) is about more than “fixing” our death-related anxieties and grieving with slightly less sorrow. We’re pushing beyond a few comfortable boundaries to give the promise of death permission to catapult us into something so much better."

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  • 3 weeks later...

Disclaimer: The following article provides opinion(s) that are non mainstream in nature. Kindly read the content with applied discernment and wisdom. And discuss with the professionals where appropriate. 

 

Therapy is a Scam! – The truth about mental health and big pharma  

 

Riya Venkateshwaran
1 year ago


"Therapy’s positive effects are impossible to deny- decades of research have proven it to be an effective treatment. Despite this, therapy is plagued with the same issues as the rest of healthcare, namely financial issues and exploitation."


Yes, you read that right; therapy is a scam. In a world where phrases like “mental health matters” seem to greet you every direction you look, it almost seems forbidden to utter the kind of remark you’d expect from your grandfather who exclaims, “therapy is for suckers!” While I don’t hold the sentiment that therapy has no value, he does raise a point: Are therapists really swindling our money? The short answer is yes, the field of professional help and the pharmaceutical industry is rigged with financial traps and emotional roller-coasters that run for as far as the skeptic’s eye can see. 

 

The last decade worked hard to destigmatize mental illnesses, and contemporary culture finally recognizes that everyone can benefit from therapeutics, not just “those crazy people that belong in the loony bin,” as the older generation says. However, if you haven’t been dragged into the mess of professional help, there’s a misconception that once you finally seek a therapist, their help will…help. 

 

Therapists are never available to begin with, and after months of waiting for a consultation, you enter Susan’s soothing lavender room, complete with a stress toy and a place to vent. But on your second visit, you realize Susan only asked variations of “so how does that make you feel?”,  made surface level insights, and suggested general coping mechanisms that could be doled out to anyone. You walk out feeling more anxious than when you walked in, and that complementary stress ball is soon to be on life support. You end up asking yourself, “is this what therapy was all cracked up to be? No thank you, I think I’ll stick to my beer and Sunday football.” 

 

The typical rebuttal is “you just have to find the one you click with!” But why should I, the patient, have to go on a wild-goose-chase for a therapist that “works” for me? They should just…work. A highly qualified therapist would be sharp and strategically personalize their treatments for each of their clients. Leapfrogging through the field of therapists illustrates a fundamental flaw in our approach to treatment. Clearly, schools of psychology need to increase the rigor of their programs and raise the standards to be a certified therapist. To put it into perspective, we easily give doctors access to our bodies; their job is to maintain our physical health. Would you trust therapists to have unrestricted access to the depths of your mind because their job is to maintain our mental health? Would you be okay with allowing a surgeon who botched surgeries sometimes?   

 

"Therapy can be life saving for some people. This makes the long wait times to find a therapist who’s right for you and the financial gates blocking off expensive options all the more harmful to patients who are seeking help."


Getting legitimate therapy isn’t the only factor draining our pockets. The pharmaceutical realm shamelessly capitalizes off the increase in diagnoses for mental illness. “Big Pharma” is a running joke amongst younger generations, because no matter what economic logic you come up with, it all boils down to a gut feeling: Profiting off of someone suffering just doesn’t sound right. Corporations are incentivized to prolong the misery of patients, forcing consumers to rely on their pharmaceuticals. It’s no secret that corporate America rarely shies away from the chance to play with lives; they certainly haven’t hesitated to use the trivialization of mental disorders to their advantage.  

 

This is also where accessibility comes into play. Your favorite pill-pushing company may brand themselves as a “family company,” but which families are we really talking about here? Prescription anxiety medication is likely to earn a scoff in most marginalized communities. We circle back to the age-old controversy: should those on the lower rungs of the socio-economic ladder still have the right to healthcare in spite of their inability to pay for it? Do marginalized groups not deserve therapists, medications and an improved standard of living? Or is it just tough luck, since they didn’t “work hard enough” for that white picket fence that anyone can earn in good old America? 

 

In the end, whether you’re rich or poor, one thing seems clear: we still have a lot of work to do in order to evolve our idea of what good, effective therapy looks like. We need to recognize these petty, stubborn mindsets are keeping us from focusing on reaching a point where the answer to “Do you think having a therapist is essential?” is “Yes.” And if we were to indulge a lofty prediction, when doctors’ physical check-ups are automated, perhaps therapists and psychiatrists will ironically become a “no-brainer”. Until then, do your research before shelling out cash for those pricey medications and wasting precious time on finding a decent therapist. Or as grandpa would put it: Don’t be a sucker! 

 

** Click here for full Article. 

 

Edited by amuse.ed
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What’s Hidden In Singapore’s Conversation About Mental Health?


Opinion Writer
OPINION WRITER
 

17 MARCH 2023

 

I remember the day I sought help for my mental health. It was in the army. It’s 12 midnight, and most of the lights are off in the clinic. There is a faint smell of antiseptic in the air. Walking into the doctor’s room, I happen to see his adjacent screen. The page?

 

Wikipedia.

 

The title? “How to make a mental health assessment”.

 

Telling him about my suicidal ideation makes him worried enough to send me to IMH. I remember the state of despair when that happened.

 

I try to convince him otherwise, that all I need is someone to talk to. He sends me anyway. I remember sitting in the army ambulance, and thinking,

 

“Gosh. What have I gotten myself into?”

 

That night, at 1 am, I find myself in IMH. I’ve been waiting for 1 hour for the doctor to see me. I feel stifled.

 

I want some fresh air.

 

Walking towards the exit, the door doesn’t open. I look for a button to press. Then the receptionist calls out from the counter.

 

“You can’t go out.”

 

The Mental Jail I Now Found Myself In


That was when I first realised that seeking mental health treatment had not just left me physically locked up, but also mentally jailed. Sat in this mental jail, I could only look out of the bars, feeling that I would not be accepted for having been treated for mental health.

 

The day after my visit to IMH, I remember calling IMH to ask them how long my records would be kept.

I wanted those records to disappear, thinking my ‘clean’ record, and consequently, my future, were now ruined.

 

I had to lie when filling up employment forms asking if I had mental health conditions before. As much as we can say that we have moved ‘beyond the label’, would an employer really take someone with a mental health condition, when he had someone ‘normal’ to choose from?

 

Even insurers didn’t want to insure me.

 

The Missing Conversation


Much of our conversation today focuses on raising awareness of mental health conditions and getting sufferers to seek help.

 

And much of the work so far is deserving of praise.

 

But mere focus on awareness and encouraging people to seek help misses the mark of what happens after someone gets help.

 

Among the interviewees I spoke to, they tended to split their lives into two portions. BC, and AD. Before Crisis, which was what led them to initially seek help; and After Diagnosis, which has confronted them with the realities of living with a mental health diagnosis. This is the experience of 2 patients who have spent time in the psychiatric units of Singapore’s hospitals.

 

Mere focus on awareness and encouraging people to seek help misses the mark of what happens after someone gets help.

 

The Cost On One’s Employment


Nadera remembers her worst experience at the Institute of Mental Health, Singapore’s only psychiatric hospital.

 

In that Class C ward, she spent days with 40 others in the ‘day area’. I thought I heard wrongly.

 

Forty, or fourteen?

 

Forty.

 

The day area is where patients spend their days. There are simply chairs and tables in the room. Their phones are kept from them. Often, not many programmes are organised for them. She saw a diversity of patients there, including one who removed her diapers to defecate on the floor. Another one started stripping off her clothes. Others were screaming.

 

There, toilets cannot be locked. Anyone can enter the toilet.

 

She was traumatised by that experience and found herself feeling worse after being discharged. Nadera has lost count of the number of times she has been hospitalised at IMH. But she continues to go whenever she doesn’t feel safe, despite previous negative experiences.

 

Nadera agrees that there have been consequences of her diagnosis, especially in job hunts.

 

I know friends who have lied about their mental health conditions when filling up employment applications. For me, there are times when I haven’t heard back after declaring.

 

I’ve learnt to not declare it first, but talk about it during the interview. I don’t want employers to make conclusions without even meeting me.

It seems that the emotional cost of one’s mental health, also has a dollar sign attached.

 

When the Cost Outweighs the Cause

 

Lishan has been hospitalised 5 times between 2018 and 2021, when she actively sought help.

 

But she had to stop because it got too draining on her finances.

 

I’ve spent $70,000 on psychiatric treatment. And I didn’t feel I was getting better.

 

Every time I saw a psychiatrist, they would say the same thing. There’s no cure for your condition.

 

Lishan was diagnosed with bipolar disorder.

 

She felt something had to change.

 

I almost felt like sometimes I was playing this role of being a patient. For those 3 years, I just wanted someone to care for me.

 

I weaned myself off my medication.

 

Since January 2022, Lishan took on a full-time job as a yoga teacher. There is clearly something different about her today, compared to when I first met her in 2019.

 

There’s a sparkle in her eyes, a spring in her step, and she even breaks into song when a familiar tune comes on in the cafe.

 

What has changed? Is there truly life after a mental health crisis? How have these patients found life again, from such dire circumstances?

 

Is There Life After Crisis?


Nadera acknowledges that there are still gaps in post-crisis treatment today. There’s been more focus on preventative, youth mental health today.

 

But we shouldn’t forget the work IMH does in treating people in crisis, or helping them after crisis.

 

When I was in IMH, I used to spend day after day sat in the day room, with nothing to do except chatting to other patients, and waiting for the meals to arrive. There were no activities.

 

After I was discharged, there was an IMH Job Club, and basic activities like sewing and baking, but these were really more suitable for people who were in more severe conditions.

 

There’s a lack of resources in expanding the work IMH does.

 

Can More Be Done For Life After Seeking Help?


Nothing is perfect, and if we poke holes in our mental health post-recovery system, there will definitely be gaps.

 

But it’s not because the government, professionals, or the community haven’t tried hard enough.

 

In August 2021, the Government’s set up the Inter-Agency Taskforce on Mental Health and Well-being. In their public consultation between May to August 2022, they shared their preliminary recommendations, one of which was to build a wider ecosystem of support in workplaces, to support persons with mental health conditions.

 

It’s a recognition that recovery from mental health is no longer just about the individual, but the wider workplace where the person can contribute.

 

Professionals spoken to shared about the very real bed crunch faced in IMH, and the manpower issues that prevail in a medical specialty that seems to have little financial reward for the difficulties involved in caring for patients.

 

The community has stepped in too. Organizations like Club Heal, have a Community Intervention Team (COMIT) to support life in the community after psychiatric treatment.  

 

Building a wider ecosystem of support in the community, and in the workforce, are certainly steps in the right direction.

 

The Individual Effort Matters Too


But for both Lishan and Nadera, their community of friends and their personal drive to improve their situation have made things better.

 

Life after diagnosis is really expensive. $150 for one session of therapy is a lot.

 

If I was feeling rich, maybe I would go more times a month.

 

But I really can’t afford it.

 

Nadera pauses for a long time when I ask her how she would encourage those facing mental health crises now.

 

I’m struggling to answer because there are so many times when I don’t want to go back to IMH. But I don’t know where else I can go.

 

I can hear the pain in her voice.

 

But I also see the tenacity of hope.

 

Nadera recently lost her father. Yet she continues to fight, together with countless others, to make life after crisis, possible.

 

The Importance of Community


The Singapore Mental Health Study (SMHS) in 2016 found that 1 in 7 has experienced a mental disorder in their lives. But 6 in 7 haven’t, and may not ever experience one.

 

If you’re one of the 6 who may never face a mental health crisis, you still play an important role in being the relationship that matters, when it feels like everything else in the patient’s life has crumbled.

 

In 2018, I volunteered in Xi’An, with a charity serving children with disabilities, who were often found abandoned in street corners, rubbish dumps, and doorsteps.

 

One afternoon, walking home with a teen with a mild intellectual disability, I asked stupidly,

 

Do you miss Mummy?

 

No I don’t.

 

I thought I heard wrongly.

 

I asked again, more firmly this time.

 

No I don’t. I have friends and aunty here.

 

Later when I went to his room, all he had was a teddy bear on his bed, and a suitcase under his bed. In the eyes of the world, he had nothing.

 

But in his eyes, he had everything.

 

Because he had friends and family.

 

Nadera concludes,

 

Going into IMH can be a scary experience. You don’t know anybody, you could be waiting in A&E for 4 hours, with people screaming around you.

It can be a very lonely experience.

 

Ultimately, people make the journey easier, and the recovery matter.

 

If COVID has taught us something, it’s that however user-friendly and accessible our technologies can be in making our experiences better, nothing can ever replace our deep yearning for relationships.

 

** Click HERE for the article

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  • 2 weeks later...

Are Mental Illnesses (MIs) Really Incurable?

 

The professionals used to attribute the mental illnesses (MIs) symptoms as "Brain chemical imbalances"

Now some wondered if this attribution is "unknown," "unconfirmed", "unclassifiable"

A narrative that has changed over the years, emphasising that mental health is on a spectrum

 

It was stated that some mental illnesses are more serious than others (SMI)

SMI such as bipolar disorder, major depressive disorder, schizophrenia, and schizoaffective disorder

Patients preferably to be on life long medications

Newer terms i.e. Complementary and alternative medicine (CAM) quietly surfaces 

Which refers to "treatment and practices that are not typically associated with standard care"

 

"CAM may be used in place of or in addition to standard health practices. 

Examples include yoga, meditation, tai chi, relaxation exercises, and other mind-body medicine techniques" 


If mental health and wellness and on a spectrum....

 

Aren't mental hygiene itself the of utmost importance? 

Since there are no exact quantifiable measurements 
No one can really draw a proper conclusion at this juncture

 

Taking it down to the nuances.... 

 

Forming an "unseemly forbearance"

that evolves over the Nth years

"Coercing" others to be medicated

Inevitably creating this POV that MI is incurable


The stark reality is.....

 

Brain akin other parts of our body will fall sick periodically if not well taken care of

But the pain of having this "sick brain" cut across the human ecological systems

It causes "dysfunctionalities" to oneself, their families, down to the community and nation

 

Resulting in unemploymentability

Some even being labelled as "a manace" to the legal system and society 

 

"The outcome of untreated MI can be devastating, detrimental and disastrous" the mainstream media said

 

And perhaps that was the very reason why MI is incurable endorsed by most parts of the world

 

A narrative written, perpetuated by the professionals

 

Are humans too quick to accept this MI narratives?

Has these narratives been helping and supporting the people with MIs and their caregivers? 

Or has it brought more harm than good, opening up many cans of worms that are no longer sealable?

 

Seems like most people has accepted the narratives as it is hence.... 

 

300ish labels "were painstakingly" created over the 70ish years 

Labels that "gave meanings to" certain "eccentric behaviour"

Causing some to be on "this spectrum of learned helplessness"

Swinging to and fro.... screaming for support and assistances

Are MIs incurable and only treatable?

One would only agree or beg to differ

Why can't more time and efforts be garnered more collectively?

Or humans are just merely just unmotivated in this fast paced work culture?


Ok to be fair...

 

One will never get to hear mental health is on a spectrum a decade ago

Acknowledging it can be non linear

There is a shift but is this shift wiser and for the better?

Only time will reveal and show its true colours 

 

Hopefully more will take up the initiative

Harmonising evidence based statistics, lived experiences and go by their intuitive 

Applying more discernment and life wisdom

Instead of gravitating where the power, authority and money are

 

Is ET simply dreaming something that is out of his reality?

 

Or is he "Hypomania-ing"?

 

This is laughable indeed, a mental health curator who is still doubting

 

ET 
23.04.2023

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Lost productivity due to depression and anxiety may cost Singapore nearly S$16b a year: IMH, Duke-NUS study


Anxiety and depression may cost Singapore around S$16 billion yearly, a study by Duke-NUS Medical School and the Institute of Mental Health found
Their survey showed that 14 per cent of respondents had symptoms consistent with depression and 15 per cent had symptoms consistent with anxiety
Those affected reported missing an extra 17.7 days of work a year and were 40 per cent less productive while at work


This brought the total value of lost productivity attributable to anxiety and depression to S$15.7 billion


Duke-NUS said that this was consistent with global findings 

 

BY LOW YOUJIN
Published April 27, 2023
Updated April 27, 2023


SINGAPORE — Anxiety and depression could be costing Singapore close to S$16 billion a year, or around 2.9 per cent of its gross domestic product (GDP), which suggests that more needs to be done to help sufferers cope.

 

This was based on a joint study by researchers from Duke-NUS Medical School and the Institute of Mental Health (IMH), which published their findings in the peer-reviewed medical journal BMC Psychiatry on Feb 14 this year.

 

In a press release on Wednesday (April 26), Duke-NUS said that the survey was done online between April and June last year, and it polled 5,725 adults.

 

To quantify the economic burden of depression and anxiety symptoms, the paper stated that a cross-sectional online survey was administered in English to Singaporean residents who are members of a national web panel curated by global consultancy company Kantar Profiles.

 

The panel has more than 500,000 people and is broadly representative of the socio-economic, gender and ethnicity distributions in Singapore.


The researchers said that the study is the first of its kind after the onset of the Covid-19 pandemic to estimate the prevalence and economic burden of depression and anxiety symptoms among Singaporean adults.

 

THE FINDINGS
The survey found that:

 

14 per cent of the respondents had symptoms consistent with depression
15 per cent, including those with depression, had symptoms consistent with anxiety


Among those who were identified as having these conditions:

 

32 per cent reported seeking healthcare to treat their conditions


24 per cent consulted a mental health provider


Duke-NUS said that 13 per cent of those suffering from the aforementioned mental health conditions made at least one visit to an emergency department, and 9 per cent were admitted into a hospital.

 

This increased healthcare costs by an average of S$1,050 a year for these individuals, it added.

 

Other results showed that the affected respondents:

 

Reported missing an extra 17.7 days of work a year, which translates to S$4,980 a worker


Were 40 per cent less productive while at work, which is equivalent to S$28,720 in economic losses yearly


As a result, this brought the total value of lost productivity attributable to anxiety and depression in Singapore to S$15.7 billion a year.

 

Of this, presenteeism accounted for 81.6 per cent (S$12.8 billion) and absenteeism accounted for 14.2 per cent (S$2.2 billion). Healthcare resource utilisation took up the remaining 4.2 per cent (S$0.7 billion).

 

Presenteeism refers to the lost productivity that occurs when employees are not fully functioning in the workplace because of an illness, injury or other condition.

 

Absenteeism simply refers to an employee who does not show up for work.  

 

Duke-NUS said that the S$15.7 billion figure is consistent with global findings.

For instance, studies in the United States before Covid-19 estimated the economic burden of diagnosed depression to be 1.6 per cent of its GDP.

The burden of diagnosed anxiety disorder is estimated to be between 0.25 per cent and 0.78 per cent of a country’s GDP.

 

The World Health Organization also estimated that Covid-19 has directly or indirectly contributed to an increased prevalence of depression (28 per cent) and anxiety (26 per cent).

 

Other estimates put the global economic burden of mental health conditions at US$1 trillion (S$1.3 trillion) a year, Duke-NUS added.

 

HELPING PEOPLE GET DIAGNOSED, TREATED


Commenting on the figures related to people suffering from mental health symptoms. Professor Eric Finkelstein, one of the study’s authors, said that the results are of concern because they suggest that these individuals are not benefitting from effective treatments.

“Successful efforts to improve mental health will have both health and productivity benefits”, he added, referring to the S$15.7 billion worth of productivity lost due to anxiety and depression.

 

Prof Finkelstein is also a health economist with Duke-NUS’ Health Services and Systems Research Programme.


Another co-author of the study, Associate Professor Daniel Fung, gave suggestions on how society can move forward from here.

 

Among them is to make greater efforts to encourage undiagnosed cases to seek treatment, as well as to expand access to peer support programmes.

Assoc Prof Fung, who is also chief executive officer of IMH, spoke about increasing efforts to improve mental health literacy and to reduce stigma surrounding mental health conditions, as well as to provide more training for general practitioners and allied health professionals to diagnose and treat mental health symptoms.

 

“(These suggestions) are all part of a successful recovery strategy for the whole population,” he added.

 

SURVEY’S LIMITATIONS


The researchers acknowledged in their publication that the primary limitation of their study is the reliance on an online panel to gather their data.

 

Even though it is broadly representative of Singapore’s demographics, the researchers said they “cannot guarantee” that their sub-sample of people with depression and anxiety symptoms is similarly representative.


This is because it depends on eligible participants’ willingness to take the survey.

 

Another limitation they highlighted was that for reasons of brevity, they had chosen to use a simpler version of a patient health questionnaire.

 

The tradeoff was that the chosen method may not have picked up all patients with depression or anxiety symptoms.

 

However, comparisons with a few other published studies available suggested that their results were “credible despite this concern”.

 

A third limitation was that they may have overestimated the economic burden attributed to absenteeism and presenteeism because they compared a person with depression or anxiety symptoms to someone who is perfectly productive.

 

“However, it is likely that people without a mental health condition have reduced productivity due to other health conditions,” they added.

 

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  • 3 weeks later...

Health Check Podcast: Fight mental health stigma by hiring someone recovering from mental illness


Joyce Teo
Senior Health Correspondent
  
Synopsis: Every first and third Wednesday of the month, The Straits Times helps you make sense of health matters that affect you.

 

Gaining employment can boost the self-esteem of someone who is recovering from a mental illness and facilitate their recovery. But the discrimination against people with mental illnesses may make it difficult for them to find work. The challenges that come with their illnesses may also make it hard for them to conform to traditional work norms such as fixed working hours. But there is help from mental health charities in the community.


In this episode, ST senior health correspondent Joyce Teo finds out more about how Mindset, a mental health charity of the Jardine Matheson Group in Singapore, is helping mental health persons in recovery, find jobs as a way to reintegrate back into society.

She speaks with the CEO of Mindset, Jeffery Tan and the head of Mindset, Ms Colyn Chua. 

 

She asks them about the challenges these persons face and what employers can do to not just help them, but to raise awareness of mental health in general. She also asks Jeffery, who’s also group general counsel and the chief sustainability officer of Jardine Cycle & Carriage, under the Jardine Matheson Group, if he has spoken openly about his mental health in the workplace.

 

Highlights

3:51 What jobs are available through Mindset?

8:34 Daily challenges faced by those in mental health recovery

10:59 Employer concerns regarding hiring those in mental health recovery

15:46 Understanding different types of mental health conditions

19:27 Tackling the stigma surrounding mental health disorders

 

Follow Health Check Podcast here and rate us:

Channel: https://str.sg/JWaN

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Website: http://str.sg/stpodcasts

Feedback to: podcast@sph.com.sg

Read Joyce Teo’s stories: https://str.sg/JbxN

 

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Some S’porean youth missed 24 days of school in past year due to depression, anxiety: Study

 

Conducted between April and June 2022, the survey asked 991 parents about their 1,515 children. It identified 104 parents whose children, aged 10.6 on average, showed symptoms of depression or anxiety.


SINGAPORE – Some Singaporean children and young adults have missed an average of 24 days of school in the past year due to symptoms of depression and anxiety, a recent study showed.

 

Nearly two in three made unplanned visits to an emergency department, and more than half were hospitalised over the past year.

 

Parents who were surveyed spent an average of $10,250 on medical care for each child’s mental health condition, translating to around $1.2 billion on the population level.

 

These were among the findings from a survey of parents with children aged four to 21 in Singapore by Duke-NUS Medical School and the Institute of Mental Health (IMH), to gauge the state of youth mental health.

 

A similar survey on Singaporean adults was published in April, and showed that one in five here have symptoms of depression and anxiety, and are costing Singapore around 2.9 per cent, or nearly $16 billion, of its gross domestic product.

 

Professor Eric Finkelstein, a health economist from Duke-NUS’ Health Services and Systems Research and senior author of the latest study, said:

 

“The real effects of untreated mental health conditions among youth will extend well into adulthood, when they are less able to obtain rewarding and high-paying jobs due to poor school performance, and other challenges resulting from their illness.”

 

Conducted between April and June 2022, the survey asked 991 parents about their 1,515 children.

 

It identified 104 parents whose children, aged 10.6 on average, showed symptoms of depression or anxiety.

These parents then filled out a more comprehensive survey with questions on school absences and performance, and healthcare utilisation.

 

Nearly 12 per cent of the young people showed symptoms consistent with depression, while about 13 per cent had anxiety symptoms.

 

In total, 16.2 per cent of the young people had symptoms consistent with at least one of these conditions. But only 15 per cent had a formal diagnosis from a health professional.

 

A total of 39 per cent of the young people missed a total of one month of school or more, and 13 per cent missed three months or more.

 

Over the past year, 63 per cent of the children with symptoms of depression or anxiety visited the emergency department and 54 per cent were admitted to hospital.

 

They visited the emergency department an average of once a year, and stayed in hospital for an average of 2.9 days.

 

In total, 77 per cent of respondents said their child received healthcare treatment for their mental health condition over the past three months.

 

Sixty-two per cent reported medication use, with 37 per cent using a daily anti-depressant or anti-anxiety medication.

IMH chief executive Daniel Fung, another co-author of the study, said:

 

“These findings point to the importance of early intervention to help reduce the risk of long-term complications and improve outcomes... For instance, if the parent recognises the symptoms and knows what to do, they could encourage the child to talk about it or suggest getting some help.”

 

Prof Finkelstein said there should be screening programmes for both children and adults to identify mental health conditions early, as well as better use of peer support programmes and increased efforts to destigmatise mental health.

 

“With the high prevalence and costs of mental illness among both children and adults, a successful mental health strategy should take on the same level of urgency as Singapore’s war on diabetes.”


Helplines


Mental well-being
Institute of Mental Health’s Mental Health Helpline: 6389-2222 (24 hours)
Samaritans of Singapore: 1800-221-4444 (24 hours) /1-767 (24 hours)
Singapore Association for Mental Health: 1800-283-7019
Silver Ribbon Singapore: 6386-1928
Tinkle Friend: 1800-274-4788 
Community Health Assessment Team 6493-6500/1 
Counselling
TOUCHline (Counselling): 1800-377-2252
TOUCH Care Line (for seniors, caregivers): 6804-6555
Care Corner Counselling Centre: 6353-1180
Online resources
mindline.sg
stayprepared.sg/mymentalhealth
eC2.sg
www.tinklefriend.sg
www.chat.mentalhealth.sg
carey.carecorner.org.sg (for those aged 13 to 25)
limitless.sg/talk (for those aged 12 to 25)

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Disclaimer: The following video on mental illness, their treatments and issues on medications may cause distresses to some audiences. Kindly watch the content at one’s discretion and discuss with the mental health professionals, if necessary.

 

** Turn on CC for English subtitles 

 

 

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Disclaimer: The following video on mental illness, their treatments and issues on medications may cause distresses to some audiences. Viewer's discretion is advised.  Kindly discuss with the mental health professionals if necessary.

 

** Turn on CC for English subtitles 

 

 

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  • 2 weeks later...

How the cult of trauma took over mental health

 

Alastair Mordey

4 June 2023, 7:00am

 

You may have noticed over the last decade a steady increase in the promiscuous use of the word ‘trauma’. A word that once referred exclusively to grievous injuries of body and mind (gun-shot wounds, PTSD, that sort of thing) can now describe virtually anything. Psychotherapists and clinical psychologists are the main super-spreaders of this hyperbolic virus, though educators, politicians and of course celebrities are now getting in on the act.  

 

But trauma is more than just an annoying buzz word. Its inexorable creep into common parlance is the culmination of aa sustained campaign to politicise healthcare that has been going on for 30 years. Along the way it has resurrected some of Sigmund Freud’s more bizarre theories about childhood development, and married them with social justice concerns to become what is effectively a secular religion. 

 

Anyone who is familiar with the work of Sigmund Freud knows that his psycho-sexual theories developed in two distinct stages. The first posited that people who were mentally or emotionally unwell had repressed traumatic memories (almost always of sexual abuse in their childhood). He eventually gave up on this theory. In its stead he developed his equally infamous theory of infantile sexuality, in which children experienced sexual feelings through different erogenous zones during distinct stages of their development. It may surprise and horrify you to learn that both theories are alive and well in the current mental healthcare establishment, where they have been rebranded into a pseudoscientific theory about childhood trauma that leads to brain damage, addiction, and disease. 

 

This Freudian reformation began in the 1990s with the Adverse Childhood Experiences Study. The ACE study as it became known, was conducted between 1995 and 1997. The lead researcher was a physician called Vincent Felitti, who worked at Kaiser Permanente’s Department for Preventative Medicine in San Diego. Dr Felitti ran a weight loss programme at Kaiser, and he had a problem. His obese patients kept dropping out. Not only that, it was the ones who were doing well who were dropping off the most. Confused by this, Felitti conducted follow up interviews with as many of those patients as he could, and what he found was shocking. Out of the 286 interviews, a significant amount reported that they had been sexually abused as children. These revelations caused Felitti to reflect on Freud’s psycho-sexual theories. What if his patients had grown up using their obesity as a protective mechanism to deter sexual predation? Maybe that was why they were unwilling to lose too much weight. Or what if comfort eating was some kind of self-medication? An ‘oral fixation’ which compensated for the nurturing they should have received as children? 

 

Inspired by these hypotheses, Felitti approached colleagues at the Center for Disease Control and set about designing the ACE study. The study asked some 17,000 patients in California’s healthcare system ten questions about adverse experiences in their childhood (which they dubbed ACEs). Specifically they asked them questions about three types of abuse (physical, sexual, and psychological); two types of neglect (physical and emotional); and five different types of household dysfunction (exposure to mental illness, substance abuse, domestic violence, criminal behaviour, and divorce or separation of parents). Those ‘ACE scores’ were then mapped onto the respondents’ current health status as adults. 

 

The results were stark. Children who experienced four or more of these ACEs were deemed two to four times more likely to smoke, and four to 12 times more likely to become alcoholic or drug addicted as adults, compared to people with an ACE score of zero. Further, the study found that high ACE scores were strongly correlated with ischemic heart disease, cancer, chronic lung disease, and even skeletal fractures later in life. It seemed that childhood trauma wasn’t just causing obesity. It was causing all manner of addictions and health problems in later life. 

 

Over the following decade Dr Felitti became something of a hero to mental health professionals. Helping professionals like counsellors and psychologists are almost overwhelmingly left-leaning, so Felitti’s work was well received in such circles. It seemed to vindicate their convictions that social ills like health inequality and addiction had purely sociological causes, and could therefore be solved only by direct government action. 

 

By the end of the decade the ACE study was so lauded that organisations like the World Health Organisation were adopting the concept. In 2012, they issued their own questionnaire (the ACE-IQ) which sought to measure ACEs across the globe. The WHO noted that ACEs can ‘disrupt early brain development and compromise functioning of the nervous and immune systems.’ So not only were ACEs causing actual organic disease, they were permanently rewiring the brain. As a result, large sums of money began pouring into research which sought to isolate the specific bio-markers of adverse childhood experiences, and the idea that early life adversity might be ‘biologically embedded’ took hold. 

By the 2010s the idea that childhood trauma causes physical illness began to seep its way into popular culture. Magazine and newspaper articles ran headlines linking childhood trauma to migraines, cancer, and autoimmune disease. Numerous cities across America (such as New Orleans and Baltimore) started initiatives to protect children from trauma induced brain damage. Universities and schools ran training seminars to create ‘ACE-awareness’ in their staff. In 2018, first minister Nicola Sturgeon gave an introductory speech to welcome some 2,000 delegates to the first ACE-Aware Nation conference in Scotland. She noted that ACEs can ‘affect children’s physical and mental health’ and vowed to make sure that ‘an understanding of ACEs is embedded right across our services.’ All of these initiatives cited the ACE study as their ‘proof’ that childhood trauma causes addiction, disease and mental illness. 

 

As of 2023, the original ACE study has been cited more than 15,000 times and ‘replicated’ in hundreds, if not thousands of other studies. But few have seriously questioned its findings, or indeed the veracity of the idea that trauma permanently damages the brain. To my mind the ACE study was misleading, both in the way it presented its findings and the types of questions it asked. The results have proved to be disastrous for the mental health of our increasingly fragile younger generations. 

 

For example, one of the ACE study’s initial findings was that a child who experienced four or more ACE’s was twice as likely to become a smoker than a child with an ACE score of zero, and that those risks climbed with additional ACE’s. What the blurb emanating from the study didn’t emphasise however, was that only a minority of people with four or more ACEs go on to smoke (13.5 per cent). Even lower rates of prevalence were observed with injection drug use and alcoholism (3.4 and 16.1 per cent respectively). Surely, if childhood trauma is the main cause of addiction, and especially injection drug use (as has been portrayed endlessly by trauma advocates such as Dr Gabor Maté, who recently gained notoriety for his televised ‘trauma-focused’ therapy session with Prince Harry) then we should be seeing more than a 3.4 per cent prevalence rate in those most effected. What this tells us as much as anything else, is that 85 to 95 per cent of traumatised children do not go on to become addicts, alcoholics, or even smokers. 

 

The way the ACE study presented its findings wasn’t the only problem. There were multiple problems with the questionnaire itself. When we look at the wording of the questionnaire, what we find is that many of these so-called ‘adversities’ weren’t actually that traumatic at all. They were subjective, vague, and a virtual open invitation to self-indulgence and grievance.

 

Take question one for example: 

‘Did a parent or other adult in the household often, or very often, swear at you, insult you, put you down, or humiliate you, or act in a way that made you afraid that you might be physically hurt?’ 

 

This is a hopelessly wide-ranging question. Given that the ACE questionnaire was quantitative, not qualitative, respondents could only answer yes or no. So if a respondent ‘felt like’ they had been frequently ‘put down’ by their parents during childhood, they could answer yes and would then be categorised as having suffered ‘psychological abuse’. 

 

Question two asked: ‘Did a parent or other adult in the household, often, or very often, push, grab, slap, or throw something at you, or ever hit you so hard that you had marks or were injured?’ 

 

Obviously a simple ‘yes’ leaves us completely in the dark as to whether the respondent was beaten up repeatedly by a brutal step father, or simply ‘grabbed’ on occasion by his long-suffering single mother who was fed up with him smoking dope in his room. Nevertheless, any affirmative answer scored a point for ‘physical abuse’. 

 

Question four was particularly weak: ‘Did you often, or very often, feel that no one in your family loved you or thought you were important or special – or [that] your family didn’t look out for each other, feel close to each other, or support each other?’ Surely this is describing the majority of the planet?

 

As for the idea that childhood adversity is toxic to the brain, this is actually a radical claim with little in the way of real evidence. In his brilliant book The Trouble with Trauma, child psychiatrist Michael Scheeringa explains why evidence for the stress-damages-the-brain-theory is so thin on the ground. The only reliable evidence that would clearly demonstrate a link between trauma and subsequent changes in the brain, he says, would be a study that captures brain images before and after the trauma (a pre-trauma prospective study followed by another one after the event). Currently, there are very few of these studies due to the obvious fact that it is not ethical to induce trauma.  

Instead there are lots of cross sectional studies. These studies look at brains after the trauma has occurred, but have no way of knowing what the brain looked like before the trauma (e.g. whether the person had an undersized amygdala, over-active pre-frontal cortex, or other neurological disability which might predispose them to a heightened traumatic response). The few before and after studies that do exist seem to point towards pre-dispositional vulnerabilities. Predisposition has also, so far at least, been the most successful theory explaining other psychiatric conditions like depression, schizophrenia, anxiety and bipolar disorder. 

 

So the trauma damages the brain theory is the outlier here, and it is frankly incredible that governments, top tier universities, and entire professions have placed all their eggs into this big Freudian-hypothesis basket.  The reasons for this bias are fairly obvious however. Pre-disposition points to genes, a less headline-grabbing area of study, and therefore not as useful for raising funds for trendy political healthcare projects.  

 

In the DSM-5 (The American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition) trauma is defined as a psychiatric disorder (Post-Traumatic Stress Disorder) which has horrendous and unmistakable symptoms. These symptoms occur (in some individuals) after being exposed to ‘actual or threatened death, serious injury or sexual violence.’ Things that are certainly outside the realm of ‘normal human experience’.

 

Psychiatrists have known this since the Vietnam war. Nevertheless, since the 1990s psychiatrists under the sway of social justice politics (and bolstered by the findings of the ACE study) have been attempting to nudge a more watered-down version of trauma into the DSM. This includes ‘complex-trauma’, ‘developmental-trauma’, ‘relational- trauma’, and other snappy, made-up disorders. These ‘knock-off’ versions of PTSD have proven to be scientifically unverifiable, and have been rejected for inclusion in the DSM on multiple occasions, but nevertheless, they remain incredibly popular with clinicians and the public because they like them, and because they fit with what they believe. This concept creep around trauma is a perfect example of how bad, unscientific ideas can completely capture the zeitgeist when they peddle the right narrative. 

 

If this politicisation of psychology is not successfully challenged, I have grave fears for what the consequences will be. If we don’t stop using the word trauma, then those who suffer from real trauma (women who’ve been raped, children who’ve been burned, soldiers who’ve been blown up by mines) will have to share their services with those who, frankly speaking, don’t deserve them. And, people with addictions and other conditions that could be turned around with the right treatment will fail, because they are being protected and wrapped up in cotton wool by health professionals who are using them to fulfil their own professional and ideological goals. This cult of trauma must be stopped.  

 

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