Thoughtfulness

A friend pointed me to Karl Stenske's recent essay over on Adoption Voices, "What Can a Tiny Baby Know?"

There was nothing in the essay I hadn't heard before, and while I agreed with most of it, there was some I couldn't back 100%. And that's fine. I did scroll to the comments a number of different times, expecting there to have been an explosion of anti-woundie rhetoric, because we all know how shitty it is for people to say their experiences as babies might have long lasting effects. It's so traumatic for some people--you know who you are--to read such things, that you spend hours crafting nasty prose just to be assholes in return. I was pleasantly surprised not to see any real rancor, or "There's no data, dumbass," or "Until a baby can talk, we'll never know." Maybe a happy adoptee or two, but that's fine. We are all entitled to our experiences. I didn't chime in because I have no desire to rejoin any PW battle of any shape.

That said, I was thinking about some conversations about my experience as a neonate I've had recently with my psychiatrist friend and some OB-Gyns at work. They've been supportive, and although medical science doesn't, at this time, engage in double-blind studies on fetuses, they are willing to believe that there is merit to my argument that my mother's stress level during pregnancy, as well as the genes she passed along to me, combined with the NICU stay with no caregiver and the phenobarbitol and the sleeping 12 hours straight by 10 weeks and intense anxiety are all part of a complicated set of circumstances that made me who I am. It's not voodoo science, it's trying to make sense of what happened to me, taking into account as many variables as I am aware of. And I care because it informs who I am now. I wish I could simply turn off the anxiety and depression switches, but there are no such things.

I remember reading a couple of years ago, maybe in a review of one of Oliver Sacks's books in The New Yorker, about how fetal/neonatal stress can cause rewiring of the amygdala that can present as/exacerbate existing predispositions for mental illness as the individual grows. I Googled some things and stumbled across the writings of an extremely intelligent psychiatrist, Kevin Turnquist, practicing in Minnesota. I spent most of yesterday devouring different essays of his, which are nuanced and insightful. I could see myself in some of what he wrote. I wished that he lived closer; I would be fascinated to get his take on my mental illness.

I almost fell in love with him when I read:

Another way that the care of the child becomes reflected in its brain development involves stress responses. When babies come into the world they have "raw" nervous systems. Their brain cells have not yet developed their full coat of insulating myelin. Intrauterine life has not prepared them for dealing with any sorts of stress or frustration. In a very real way, humans are born without the capacity to soothe themselves. We must count on others to provide that vital function initially, and to eventually help us to acquire it for ourselves.

When babies don't have that attuned caretaker to sense their distress and comfort them the painful feelings continue to mount. Eventually what has been referred to as a "catanoid reaction" occurs. The baby's nervous system essentially shuts down in an attempt to manage the negative feelings. If that process happens often enough there will be fundamental changes in the way that the brain's emotional apparatus develops.

That was me! The catanoid reaction. I shut down, and my ability to cope was hindered by lack of consistent, attentive caregiver over those first few months. Even though my parents are wonderful and picked right up, I was damaged. Telling me that I am making it all up in hindsight is not only wrong, it's more about the insecurities/power issues of the people saying such bogus bullshit than it is at all related to me, my experience, and what actually happened. And what my parents told me, moreover, about their experiences with me as a preverbal infant. Back in 1969, before Verrier, before any "taint" of "voodoo scholarship" could have clouded their perceptions.

I was ruminating at length about what Dr. Turnquist says about escaping into the past. I am so guilty of escaping into my head, into books, into the past to fuel endogenous opioid release. Anything, anything other than feeling what I am living. It's a coping mechanism; at least I am not drinking, abusing drugs, or sleeping with anything that walks by. But it is very sad, in some ways, to lead a life based on paper. I was thinking about how unwilling I am to let go of my books. I need the paper in my hands, and I remember when and where and why I bought most of my books. Sometimes I feel my books love me/understand me more than people do. And maybe that's just another tragedy I have to live with.

An important but often overlooked facet of human behavior is our capacity for generating comforting thoughts. From the very first time that we learn to soothe ourselves with the thought that "Mommy will come back" we utilize thoughts that are designed to bring us hope and ease our anxieties. Each of us has our own repertoire of thoughts and memories that we can turn to in an effort to feel better. Fantasies of romantic conquests, wealth, being admired, and high ranking in our social groups are common themes in the thoughts that we rely upon to produce positive emotions within our own brains.

The problem is that this unique human ability to generate thoughts that make us feel good is reinforced by brain chemicals that have an addictive quality. The more we turn to thoughts and memories to feel good, the stronger is our tendency to live in our inner worlds. This tendency to keep attaching positive emotions to images of ourselves also opens us up to despair. Humans can't help but compare current representations of ourselves to underlying idealized images of how good we think we should be.

The greater the disparity between the genuine image of our self and the idealized version, the more severe are our feelings of depression and existential pain.

I am drawing these quotations from one particular essay of his, "Implications of the Emerging Model," that discusses the state of how we think about mental illness in the United States and the problems inherent in current models of treatment. He talks about how difficult it is to listen and hear people who walk different paths than we do; how we expect what is to clear to us to be clear to them, or for them at least to be receptive to what we're saying. Sadly, they're not. I loved how he closed his essay, and I encourage everyone to think about their part in this, in dealing with people with mental illness (and you could substitute "adoptee" for mentally ill person--not that I am saying that all adoptees are mentally ill). It's just what he says makes sense, and we as rational, thinking people should work together, not belittle one another. How can we apply this to working together so that we call have our OBCs?

A natural tendency among humans is to believe that people who are different than us are somehow less human than we are. Without the power of this mental mechanism we'd have a hard time killing other humans that are seen as enemies, much less their innocent children.

When someone on a local editorial page suggested that we've come to view people in the Middle East as being less human than Americans another writer responded by angrily asserting that those people are less human than we are. Perhaps that gentleman should travel more. An inescapable conclusion when people visit other cultures is that humans are pretty much alike everywhere. They may have different languages or religious beliefs but as we go about our day to day lives the differences are pretty minimal.

The unfortunate result for mentally ill people is that we also extend these types of beliefs to them. Because they seem different from us we may conclude that they're less human than people who don't have suffer from mental illness. And when we conclude that any group is less human than ourselves all sorts of terrible treatment can be "justified."

Compounding matters is a tendency on the part of mentally ill people to be consumed with self-loathing and to believe that they somehow deserve to be treated badly. As Nietzsche pointed out, "terrible experiences make one wonder whether he who experiences them is not something terrible."

and

The rationale for change

It's always tempting to advance moral arguments in favor of the types of changes that have been suggested here. When a person has been around poor and disadvantaged people for a long enough time those ethical points of view can be extremely compelling. And these moral arguments work well on other people that have similar backgrounds and experiences as us so it's natural to assume that they'll make sense to everyone else.

But our understanding of, and sentiments towards, people that seem different than us are, ultimately, impossible to separate from our feelings about ourselves. And those are very hard to change. People that, at their very cores, don't believe that their own lives are worthwhile or meaningful will not be touched by arguments that are based on ethical assumptions about the value of the lives of mentally ill people.

The more persuasive arguments for change that arise from the emerging model of mental illness must be based on a realistic appraisal of human nature. When we more fully understand what it means to be mentally ill and appreciate the kinds of things that the people suffering from these disorders need to function more independently it will make sense to redefine the basic safety net that our society provides for its most disadvantaged and marginalized citizens.

The arguments in favor of efficiency and cost-effectiveness will prove most convincing over the long haul. It will be much cheaper in the end to provide a true safety net that will catch everybody than to maintain one that's full of holes, then keep spending lots of money on the people that the net didn't catch. And people need to know how far they'll drop before the net will catch them. When everyone can count on receiving the basic essentials necessary for a decent quality of life the decrease in those stress hormones will be almost palpable.

The real implication of the model of mental illness that is now emerging is that we're going to have a great many mentally ill people in our society whether we like it or not. They aren't going to go away when some new and better medication comes along. Mental illness is in our genome and may be increasing because of ways that our society is evolving.

Recovery from these disorders will not come in the form of a capsule alone. Even when the medications work at their best there will still be residual problems that many of these people won't be able to negotiate on their own.

Creating safe and humane living environments for the adults that suffer from these disorders - environments that provide actual opportunities and incentives to function as independently as possible - will be more effective than continuing a system that promotes dependency and dysfunction. Providing a "good enough" environment for our children as they develop their brains will reduce the number of people that will eventually depend on society to support them.

Is there any part of the political spectrum that's opposed to these outcomes?