Relapse is Not Recovery

Glacial_grooves

Is it a groove or a rut? Glacial grooves take time to form, so do our habits, addictions, and recovery efforts.

You have been biting your nails for years and are tired of it. Your nails are bloody stumps and they hurt all the time. So you decide to make a change. You start with a spray to make your fingers nasty enough that you won’t want to put them in your mouth. Lexapro becomes a regular morning companion at the advice of a doctor. And you start meditating 20 minutes every morning to relax because the main problem is anxiety and nail biting is a symptom. You feel great. Your fingers are feeling wonderful, you are more relaxed, and you look down and thing, “I could be a hand model.”

Then one day it’s raining and cold outside and you have a major deadline at work that day for something you are not sure will get finished. Tired after weeks of hard work you refuse the Lexapro, the spray, and the meditation. When you get home that night, you need bandages because your fingers are bloody stumps because you chewed them to a pulp that afternoon. You take a Lexapro and go to bed, back at Day 1.

Was going back to biting nails part of the recovery process? I have heard some ideas supported that say relapse into the very behaviors that a program of recovery is trying to prevent is part of the process of recovery itself. But that is like saying sitting down is a necessary part of running or that getting into a car accident is a necessary part of driving. Sitting down is highly probably and a car crash is probable but less so, but both are symptoms or consequences of both running and driving. Neither must happen for running or driving to be possible.

It’s a fact that relapse happens. Depending on the strength of one’s addictive patterns of behavior, it might happen more than once. But even if relapse is highly probable or if it is even inevitable in some cases, it does not make it a part of recovery. Highly probable does not mean necessary. Facts are not necessities. So what is relapse?

Relapse is a symptom of addiction, not recovery.

This is important. Nail biting probably won’t kill you. But alcohol, cutting, drugs, and even compulsive eating can. Stopping medication or other important behavioral modifications in illnesses like depression, bipolar, or schizophrenia stir the pot for a suicide soup. Relapse in any of these cases is not part of recovery, it is part of the illness from which you are trying to recover. And it can kill you.

When we have habits that are powerful shapers of our lives and around which our relationships and behaviors seem grounded like some gravitational or magnetic force, escape velocity is really hard to achieve. Like a ball tossed in the air, the tendency of our bodies and minds is to fall back down to the place where “normal” has existed as long as we can remember. But that’s the delusion. That “normal” feeling of being stuck to the addiction is anything but natural. It’s not a natural part of the brain to do things that put our very survival as human beings in danger. The brain is there to keep us alive, not kill us. Yet with many of these strong addictions, the brain turns on us like a bad scene from M. Night Shayamalan’s terrible film The Happening.

Relapse happens because addiction is powerful and change is difficult. Change in order to stop addictive behaviors seems insurmountable because addictive behaviors have formed absurdly deep grooves that our lives seem to automatically follow whether we want them to or not. Getting out of these patterns requires a radical program of behavioral change to fill in those old grooves and make some newer, healthier grooves for our lives to follow. This takes time, patience, and a hell of a lot of hard work and consistent, repeated effort. Relapse shoots us back into those old grooves and when we fall into them, they feel deeper and more impossible than before. For many they are inescapable.

Relapse is not a part of recovery, it is a symptom very addiction that people are trying to recover from. That distinction is important enough to make because it will save lives.

Believe It. Alcoholics Anonymous is Rational

Alcoholics Anonymous is often referred to as a “cult,” “sexist,” “faith-based,” “false,” or any other combination of terms that serve it up as a method people use to get and stay sober that is ineffective and even destructive. The first step “We admitted we were powerless…” is where the snag happens and after that it is all downhill. At that point there are too many mentions of God and too few licensed professionals leading meetings for it to have any scientific muster. If that isn’t enough, the statistics will then come out suggesting a less than 10% success rate and not going to any meetings and getting sober on one’s own are just as effective. Finally the real kicker: AA will say that it is your fault rather than the program’s if you go out and get drunk again. Talk about a punch to the ego.

The Atlantic offers up another addition to this narrative with Gabrielle Glaser’s article, “The Irrationality of Alcoholics Anonymous.” In this she asserts that AA is essentially anachronistic and its ideas of powerlessness and a higher power perpetuate an outdated and ineffective method for treating addiction. The simple idea that healing from alcohol addiction can happen with an abstinence only approach as AA is complicated by some who argue that “going cold turkey only intensifies cravings” or “likely deters people with mild or moderate alcohol-use disorder from seeking help.” If you talk to any alcoholic newly separated from booze, the idea of abstinence sucks. However, if you talk with anyone with long-term sobriety, it was the best decision they ever made.

Glaser does point out that addiction treatment in the US does not get the attention it needs to be more effective and that too many rehabs and treatment centers rely on AA to do the work for them. I do agree with her here, but for different reasons. AA and rehab were never supposed to be married this way. Bill Wilson, co-founder of AA, had an idea of setting up hospitals to take in alcoholics, but that idea was quashed before the first edition Alcoholics Anonymous was ever published. It was always understood as something dangerous that would pull people away from the mission of the group itself. As Bill Wilson writes regarding the non-professional nature of AA in Tradition Eight: “Every time we have tried to professionalize our Twelfth Step, the result has been exactly the same: Our single purpose has been defeated.” It’s a relationship that does not produce the best results and has skewed the core of what AA is to those who have recovered from alcoholism in its steps. People in AA know this already.

Glaser’s “AA” is Straw

The AA program was intended to work only among those who has a desire to stop drinking and then to move forward with the entire program. The program itself starts with cessation of drinking. That’s just Step 1. Every step after that has to do with achieving and maintaining a “spiritual experience” which is also called a “psychic change.” Glaser talks about one small piece of AA and ignores the rest of it which would conveniently address her subsequent criticisms. Her solution is that there are ways to help addicts to drink moderately with the use of drugs among other solutions that are available. She’s right, and no literature in AA disputes this. There are other methods and AA is not for everyone.

Moreover, AA’s program teaches that drinking itself is a symptom of a deeper psychological problem. But in good straw-man building fashion, she does not take us there in the article.

Though our decision was a vital and crucial step, it could have little permanent effect unless at once followed by a strenuous effort to face, and to be rid of, the things in ourselves which had been blocking us. Our liquor was but a symptom. So we had to get down to causes and conditions. (Alcoholics Anonymous, p. 64)

Glaser talks about alternatives. Among them, “motivational enhancement, a form of counseling that aims to help people see the need to change.” Or, that AA is not equipped to address issues of other mental health issues. This is where she shows that she has done some extraordinarily shoddy research into AA itself. The literature in AA is very clear about how to work with physicians and the importance of working with the medical community.

We recognize that alcoholics are not immune to other diseases. Some of us have had to cope with depressions that can be suicidal; schizophrenia that sometimes requires hospitalization; bipolar disorder, and other mental and biological illnesses. Also among us are diabetics, epileptics, members with heart trouble, cancer, allergies, hypertension, and many other serious physical conditions. Because of the difficulties that many alcoholics have with drugs, some members have taken the position that no one in A.A. should take any medication. While this position has undoubtedly prevented relapses for some, it has meant disaster for others.

She also describes the AA program consisting of “attending meetings, earning one’s sobriety chips, and never taking another sip of alcohol.” In fact, if you present this to anyone in AA who has long-term recovery under his or her belt they will laugh at you and tell you that AA approached this way is a recipe for relapse! The examples she gives are simply examples of people who may have had bad experiences in AA. But to someone with long-term sobriety, these examples are of people who did not do the work to change their lives in a way where the cravings desisted. Glaser fails to talk about all of the stuff in the steps that restructure life and redirect behaviors in ways that are exactly the opposite of the self-seeking behaviors of the active addict.

“J.G.” in Glaser’s article, who rationalizes his way into “a cycle of bingeing and abstinence,” is not a new character in AA lore. Again, the person sober for a while will tell him that he might not be done researching his own drinking and is probably not ready for AA just yet. That guy doesn’t want to get sober, he wants to drink. But no one in AA is stopping him. Abstinence is not the cause of his bingeing, his alcoholism is.

Trading One Dependency for Another?

Words such as “retention” and “success” are frequently thrown out in articles such as Glaser’s without any description of what they the measure of them is. Is someone who gets sober in AA for a decade, then goes out for a night of binge drinking a failure? What does it mean to “get better?” Perhaps to Glaser dependence on pills in order to resist cravings is the way to go.

She plans to keep taking naltrexone indefinitely, and has become an advocate for Sinclair’s method: she set up a nonprofit organization for people seeking information about it and made a documentary called One Little Pill.

That might work for some people, but without working through all the other shit that alcoholism brings with it, you are just slowing down the physical cravings. Alcoholics destroy the lives of those around them, not only their own. Unless you can clean up that mess, nothing will really change. If you just want to slow down your drinking, AA is just not the place for you. But if your drinking has been the primary cause in what you perceive to be a majorly fucked up life, a pill is not going to resolve that – even if it takes away your physical cravings to get lit.

The core problem with Glaser’s article is that it focuses on the physical problem of alcoholism which the Big Book talks about, but then ignores the majority AA program which is primarily a pragmatic method to radically change one’s thinking not just to stay abstinent from alcohol, but then to become a more honest and helpful person than what one was before hand. It is primarily a program about solutions rather than problems. It is about replacing one set of behaviors and environmental conditions with another in order to produce different behavior outcomes after recognizing the root causes for one’s drinking – causes that are discovered in steps 4-9.

Seen in its fullness, AA is about as rational as any program of recovery can get. When you see the rational work done between a sponsor and a sponsee you can see how rational it is and how striking it is compared to many of the modern programs of behavior and cognitive therapies used in other addiction treatment theories.

As one of Glaser’s critics says, “What keeps me in the AA rooms despite this is, first and always, the people–a community whose impact is hard to grasp unless you are part of it (which the self-proclaimed non-alcoholic Glaser most definitely is not).”

Church: You Make it Impossible to Love You

The film 28 Days begins as uncomfortably as any film could. Sandra Bullock plays Gwen Cummings who after a night of drinking and sex arrives drunk and late to her sister Lily’s wedding. She proceeds to make a complete fool out of herself and destroys anyone’s chance at having a good day.

The line that always gets me is uttered early on by Lily. She looks Gwen in the eyes and says, “Gwen, you make it impossible to love you.”

It is impossible to love an addict. Addicts are the most selfish people on the face of the earth. Addicts have a special brand of narcissism that is deadly and out of control. It is so out of control that the addict is often the last to realize he or she has a problem and in many cases will refuse to acknowledge a problem all the way to the death-bed. I have known people who literally drank themselves to death still convinced that they did not have a problem. As the Big Book of AA says alcohol is “Cunning, baffling, powerful.”

Unfortunately addiction and all of its vicious symptoms of self-centeredness and blatant self-destructive behaviors are not limited to the addict alone. These are behaviors that all of humanity engages in to some degree. The Buddha was aware of this problem. In his teaching everything is suffering and everything is suffering because we can’t let go of anything even if every power of reason tells us that holding on will hurt us and others in the process. If our beliefs about God are challenged, if our property is in danger of getting wiped out or stolen, if we might lose a friend or look bad in front of someone else, or if we get caught with our hand in the cookie jar, our first reaction is to tighten our grip. The threat of losing something is far more powerful than the lure of getting it.

The Christian saints and mystics are very intimate with their discussion of the passions and how our desires latch us on to everything that is not God. It is this addictive behavior that only fuels our ignorance to the good things of the world. Following our passions not only pulls us from God, but pulls us from the people were are supposed to be. The more we refuse to let go of what makes us feel safe and what makes our identity feel solid the more we hurt ourselves and others. The one source of identity that we are to seek is the mystical union with God as God is, not as we insist God to be.

Detaching from the world as we understand it and checking ourselves against the often brutal fact that we are not the center of anyone’s universe undercuts everything we grow up believing about self-esteem and the rewards of the endless popularity contests of a sick Western society. The religious ascetics, mystics, and monks dumped all of this by traveling to caves and deserts to find God and liberation. Their discovery is that God is inside of us. The problem is that the noise and psychological pollution of the world are so strong we are clueless to that simple fact.

Not all of us will go to caves and deserts. So what do we need to do?

The foundation for our spiritual malady is repentance. Repentance comes with honesty. Honesty to any addict can come only when others hold a mirror up to us and tell us more about the truth of who we are. Those who tell us only what we want to hear are called enablers. Those who tell us what we need to hear in order to recover from our world sickness are friends. But if the truth doesn’t sting a little, it’s probably not true.

The church today is loaded with enablers. It is loaded with people so blinded in their own biases and opinions both of their selves and others, that admitting personal responsibility for wrong doing is nearly impossible. From all of the crap surrounding both Tony Jones and Mark Driscoll to all of their apologists; to the crazed behaviors of Bob Jones’ casual way of dismissing its own history of mishandling sexual abuse; or the untold millions of dollars pilfered off the desperate, sick, lonely, and elderly by the likes of Benny Hinn and Robert Tilton; to the bizarre meanderings of Pat Robertson or the sickening cover-ups of Catholic bishops to avoid condemnation for complicity in sexual abuse; the only apology we hear is the kind that is a self-defense rather than a contrite begging of forgiveness.

Worse, even when it seems like an act of forgiveness, it is turned with an amendment of self-defense. Such a dodge nullifies any attempt at repentance. Anything after “but” is indeed bullshit.

Admitting when we are wrong is healthy but somehow we too often have the false idea in our heads that it makes us weak and weakness is a bad thing. The truth is that the admission of wrongdoing and the act of repentance is an act of admitting we are already weak. Humans are fragile creatures. The lie is the persistent bull-headed belief that we must be strong individuals in the face of everything that comes against us. That’s exactly what hurts us.

Even this can go too far into the territory of self-pity. This is also horribly exhausting. This is where we are so caught up in feeling lousy about ourselves that we still refuse to do anything to change. We beg people to look at how pathetic we are rather than doing something different to be less pathetic. This is no longer repentance, it is despondence. Progressives get this way because the expectation of moral purity might be too high. I am not talking about purity, I am talking about honesty.

When a group of people vacillate between bull-headed denial and self-defense on the one hand, and despondence and self-pity on the other, I don’t know about you, but I am done with that group. The only reason I have spent time as a religious person and with religious people in the past is because there is a nourishment that take place where somehow I feel that everything will be ok even when the evidence is to the contrary. Faith and hope merge in a beautiful dance. That’s when religion is at its best.

But the church is not at it’s best.

It’s hard to fill a bucket if people are pricking holes in it. The church is emptying out faster than anyone can fill it and right now it is becoming more and more impossible to love. It is a zero-sum arena of people fighting for self-interest and in that environment, it is not sustainable.

Do your part. Repent of something. Make amends with someone you have wronged and expect nothing in return. Lord knows we have enough people out there who simply refuse to do so.

Winning is Not the Only Thing

“Winning isn’t everything, it’s the only thing.” – Vince Lombardi

America is addicted to winning.

Competition is king in the United States and fear is a tool used to gain advantage over another. It is symptomatic from news broadcasts to advertising to politics to healthcare. It’s keeping up with the Joneses or a getting a better deal on a product than someone else. Sports are only the obvious venue for the relentless drive to “be the best.” If you are not the best you are a loser or a second class citizen. You are entitled or desperate for handouts. You are merely siphoning the wealth of winners rather than pulling yourself up and “getting a job” as if that is the one solution to all of society’s ills. Just shut up and compete.

The pressure to be perfect and the shame of being left on the bench or on the losing team is intense and exhausting.

One McLean elementary school recently asked for a presentation on whether its students should take the SAT or ACT, college admissions tests at least seven years away. Bowers’s husband, Bruce, almost stopped coaching girls’ soccer because of the win-at-all-costs attitude. Some other parent-coaches, he says, would spend weekends going to games to identify the top players so they could try to recruit them. “It really meant something to them to have the cream of the crop and win,” he says. “And this wasn’t travel soccer. This was when the girls were 7 or 8.”

There are always losers and the left behind because we live in a society that values the zero sum game. We don’t value the tie game or the appreciation of a good match. If there is no winner then the game isn’t worth much. But even that’s not enough.

As much as we love winners, we also like to watch others lose. If we can’t root for someone we can always root against someone. We create celebrities only to tear them down; we absorb an endless stream of negative political ads and have a sick pleasure in watching those with plenty lose it all.

There is a serious disconnect. Schools and companies require people to work in teams and to have the social skills to be effective with others. We know that cooperation guarantees a better outcome for all parties involved. A little bit of sacrifice for the good of the community and the state goes a long way towards balancing the scales of justice. But it means either not being at the top of the pecking order or at the very least delaying it.

Having less means more happiness and more time to be with each other rather than fearing someone stealing our stuff or our freedom. Cooperation requires discipline, patience, prudence, and all of the basic virtues of working hard for our own happiness and the happiness of others. Wouldn’t it be great to live not in fear but with a little more faith in humanity?

Maybe Howard Beale was right. Maybe all of us have to get mad as hell, together, and not sit by, idly accepting the toll of human life and dignity that the unfettered drive to win exacts on our society.

Breaking the Cycle of Addiction

Mary Elizabeth Winstead drinking in the shower in Smashed.

Mary Elizabeth Winstead drinking in the shower in Smashed.

We know that celebrities like Philip Seymour Hoffman die of addiction. He is not the first and sadly will not be the last. Addiction taken to the point just before the addict dies is a hopeless condition. Right at that breaking point before death is the best time to admit that he or she needs help.

There are millions of people in the world right now who are at that breaking point. I would not be surprised if the majority of people in the world at least know someone who has been an addict at some point. It is that ubiquitous. I was at that breaking point a few years ago. I stood at the turning point between death and doing something else. I chose to do something else. I stopped drinking.

But I want to qualify this a little.

I stopped drinking not because I believed I was an alcoholic. I believed alcohol was actually solving my problems on a daily basis.  Nothing in my life had become totally unmanageable to me. So what if I was unemployed, depressed, scared of life, lonely, morally bankrupt, and in debt. Everyone had those problems once in a while. So what if I drank a few glasses of wine (at least a bottle’s worth) followed by a couple of gin and tonics and maybe a couple of white Russians to cap a night off. Going to bed a little drunk helped me sleep. I hated myself, but I could always rely on alcohol to make me feel better when I needed it to. Normal stuff, right? Alcohol was my solution not my problem.

Until I stopped.

Two days after I stopped I was like a lion in a cage hungry for a steak. I paced around the house with anxious sweat hungry for a hit of my favorite juice. As the anxiety increased, I knew something was wrong. This was Wednesday. By Friday I was sitting in my first meeting shaking and holding back tears. I could barely hold a cup of coffee, and my mind raced faster than it had before. I knew that my drinking habit was not normal.

Most people can have a drink after a meal and put it down. Most people can drink half of a glass of wine or not finish a beer and be ok with that. Most alcoholics will drink until they can’t physically drink any more. The last time I got really wasted I was in Louisville, KY to celebrate with a good friend. Before we even got to the bar I secretly pounded two beers. I drank a pitcher at the bar. Everyone else left to go home. I hooked up with another group of people and collected all of the half consumed pitchers from my previous group and finished all of them. I then got back to my friend’s place where I drank three more beers and had two glasses of wine to cap off the night. To me this was a normal pattern. I drank like this when no one could see it. I drank with friends and then got drunk alone.

Upon waking the alcoholic will either have a drink to stop the craving, or will crave all day until the clock strikes “drinking time.” This craving is like drinking water in the blazing summer heat. Yet you always feel parched no matter how much water you put in your system. Even as your stomach can’t hold any more, you are still thirsty. Imagine stopping with that feeling in your mouth. It would drive you insane. That is kind of how an alcoholic feels after he or she comes full stop. It is agonizing.

The problem starts in the mind that says, “I must drink to feel normal.” Then it becomes physical where the body says, “I need to keep drinking because I cannot stop whether you like it or not.” Getting out of that cycle requires long-term re-wiring of the brain and that means approaching life in a totally different way. This is a chronic illness of the mind and body that requires ongoing treatment. But you have to want that continued treatment for it to work. As soon as the addict stops that treatment they are at risk of dropping back into the vicious, self-devouring cycle of the body and mind.

There are millions who are trapped in that cycle right now. Some are well aware they are in it and are either not sure how to break free or are too damn scared at the prospect of not getting the next hit. Some are using alcohol and drugs to subdue symptoms of mental illness they are unaware that they have. These are the people who want to stop, but are so trapped and broken they don’t even have a clue where to start.

Those who really don’t want to stop their addictions or who want an easy way out won’t stop feeding. It’s unfortunate, but we can’t expect everyone to walk into a 12 Step group and stay sober. Once in a while – it could be 22 years from the first day of sobriety – that thirst will creep back in and without a group of sober people to help ward off that feeling of needing a drink, the addict places him or herself in great danger. Staying connected with sober people on a regular basis is the path to continued sobriety.

I am glad that one death has sparked a national conversation about addiction. My fear is that after the media bump dies down, addiction will be a news story that bores us unless God forbid someone like Robert Downey, Jr. gets drunk again.

Here are some places to get information and lifelines if you think you or someone else needs them. Remember, this works only if you want it. Sobriety can’t be forced, it must be chosen.

Addiction the Terrorist

Overdose rates have tripled since 1990

SOURCE: xhttp://www.cdc.gov/homeandrecreationalsafety/rxbrief/

Addiction is the most dangerous terrorist in our culture.

It does not care about success, status, fame, family, children, or wealth. It is a predator always hungry for its next victim. Once hooked on the drug, the addict has no choice left but to consume.

We call rich and famous addicts “troubled souls” or “frustrated artists.” The homeless are “junkies” or the dregs of society sucking on the teat of the sober who take refuge under taxpayer supported bridges. Addiction does not care about any of this. If it can bring down the rich and famous the prize is only that more valuable.

Philip Seymour Hoffman died not because he was a depressed artist, a man with demons he could not get rid of, or someone who succumbed under the pressure of fame. He died because he went back to drugs and took another hit. He was an addict who chose to get high again. It is the same for him as it is for any addict. Addiction killed Amy Winehouse, Cory Monteith, Whitney Houston, and a slough of others.

Once Hoffman used again, he gave up his choice to stay sober. There is no “cure” to addiction. Addiction is a chronic illness that needs regular treatment with people who can help the addict work through the symptoms that could lead to using again. The key is that you have to want to stay sober. One has to make the choice to continue that treatment and to keep it as the priority in life. Without sobriety everything else is placed in harms’ way of being destroyed.

There is no justifiable reason to drink or drug again.

Hoffman’s “demons” are irrelevant. They are no more and no less than the demons for the addict who has nothing after his or her addiction took away every material thing and meaningful, human relationship.

What could he have done? Gone back to meetings, found a sponsor to help him get back on his feet, got honest with the power that the drug had over his life, and started the process of healing all over again. This is the same solution that has worked and continues to work for thousands.

The AA “big book” calls alcohol “cunning, baffling, and powerful.” There is no reasonable explanation for why addiction terrorizes us. Perhaps we are looking for easy answers to rationalize death from addiction. These easy answers let us dismiss the problem and move on with our lives as if the problem will never touch our families, friends, and loved ones.

Tell that to Hoffman’s family and the families of the thousands who die each year to addiction.

Addiction is a terrorist. It is laying in wait to jump you at the right time and place.

Be aware. All any of us have to do is not take that first hit. Not using is the only guarantee any of us has that we will not be taken captive by this insidious foe.

Hiding in Plain Sight: College and the Mentally Ill

Stigma and mental illness

There are students in deep pain and struggling with emotional problems and mental disorders all over college campuses.

Most of us have no clue who they are.

As Kay Redfield Jamison, co-Director of the Mood Disorders Center at Johns Hopkins University, recently said to a group of Northwestern University Students:

“No one noticed that I was in any way different,” Jamison said. “I had no idea how I managed to pass as normal in high school, except that other people are generally caught up in their own lives and seldom notice the despair in others if those despairing make an effort to disguise their pain.”

Jamison is not only a leading scholar of mood disorders, she is also diagnosed with bipolar disorder. She wrote her story of suffering, recovering, and managing her own illness in the book An Unquiet Mind.

If we sense that something is “wrong” in someone’s behavior, the attitude of the “rugged individual” might take over.

If only that person would just be happier, calm down, keep their mouth shut, stop being so impulsive, stop being so rude, or stop being so quiet and awkward. Mental illness is just a phantom problem. It’s really an issue that the individual must resolve on their own. If people would take more responsibility and just act differently, all would be ok.

A few facts:

  • Public rejection of the mentally ill is far more common than not. Socall & Holtgraves (1992) argued that “a mental illness label, regardless of a person’s behavior, can result in public rejection” (p. 441).
  • Stigmas about mental illness seem to be widely endorsed by the general public in the Western world” (Corrigan & Watson, 2002).
  • A CDC report (2012) found that while most adults believe treatment of mental disorders is effective, less believe that people are caring and sympathetic to people with mental illness.
  • Coverage of mass shootings and the near immediate link to mental illness do not help public sentiment towards the mentally ill. Rather, in a study published by the American Journal of Psychiatry (McGinty, et. al., 2013), “The stigmatization of people with mental illness may lead to a reluctance to seek treatment or raise other barriers to care” (Barry, 2013).
  • Those with mental illness may internalize public stigma and as a result will be less likely to self-disclose their problems. This is in spite of the growing body of research showing that self-disclosure has positive effects for the mentally ill person and to reduce public stigma (Hyman, 2008).

Disclosing a mental illness is a big risk. If one encounters public stigma about a mental illness the results can damage reputation, employment, friendships, etc. Even if these are not facts, the risk of further alienation is a problem that most of the human race would rather avoid.

For those who aren’t even sure that they have a mental illness but just feel different about the world and their identity, reaching out for help might be compounded by all of these factors. They will go undiagnosed and untreated for illnesses that they have no personal power to manage without help.

When we bring these issues into an environment where often thousands of young adults live, work, and play together it can be a cauldron mixing together a dangerous brew. When we add substance abuse to mental illness the problems worsen. It is then that violence is more likely. More students may bring their drug habits on campuses that started in high school. Add to that fact, 80% of college students will drink and half of those will binge drink.

Students need to feel safe in order to self-disclose that they have either been diagnosed with a mental illness or feel that they might have something wrong. College is a petri dish of social experimentation and dysfunction and mental illness is just not a good fit.

The environment must do a better job of reducing social stigma and giving the mentally ill a safe space. Colleges have made a strong effort to give women and minorities a safe place on campuses, and it is time for them to do the same for those with mental illness if anything is to improve.

Jamison spotlighted Harvard’s improvement in mental health services as an example of the important role universities play in advocating for students.

“I think if (support) does not come from the president’s office, you may as well kiss it goodbye,” Jamison said. “The president’s office has to take this really seriously, and commit money to it, and time.”

___________________________________

Sources:

Barry, C. (2013). Media coverage of mass shootings contributes to negative attitudes towards mental illness. In Johns Hopkins Bloomberg School of Public Health. Retrieved 10/09/2013, from http://www.jhsph.edu/news/news-releases/2013/webster_mass_shootings_mental_illness.html.

Centers for Disease Control and Prevention, Substance Abuse and Mental Health Services Administration, National Association of County Behavioral Health & Developmental Disability Directors, National Institute of Mental Health, The Carter Center Mental Health Program. Attitudes Toward Mental Illness: Results from the Behavioral Risk Factor Surveillance System. Atlanta (GA); Centers for Disease Control and Prevention; 2012.

Corrigan, P., and Watson, A. (2002) Understanding the impact of stigma on people with mental illness. World Psychiatry. February; 1(1): 16–20.

Hyman, I. Self-Disclosure and Its Impact on Individuals Who Receive Mental Health Services. HHS Pub. No. (SMA)-08-4337 Rockville, MD. Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 2008.

Socall, D., and Holtgraves, T. (1992). Attitudes toward the mentally ill: The effects of label and beliefs. The Sociological Quarterly , Vol. 33, No. 3 (Autumn, 1992), pp. 435-445.