Thoughts 'from Depression' on a Spit-Snow Night
About Big-Red-Budget's Impact on Mental Health--
With Some Demographic Observations
Re 'Lunatic Kentucky'
I am maxxed out on accounting problems about at the level of trying diligently to keep my books 'black' catch as catch can. From the look of it though there is a new imperative to learn something about high-level bookkeeping, as this bears -- not so immensely on me-- but on the not-as-fixed or far-along-the-line as me, and my heuristic of availability here is mostly into the area of mental-health-consumer-psychology. But there are times when hyper-readily-bored little nut re 'the books' needs to perk up-- listen-- to the pursestrings-pullers, here now making venue in Frankfort (Kentucky's state capitol.)
Here, the Commonwealth/State budget is held up by the Gov as being in crisis. He is 'Donkey' party and the Elephant-Party Majority Leader of the Senate (David L. Williams) predictably is 'aginer' [just part of the job responsibility of the-loyal-opposition] about just-how-dire things are-- but even Williams seems compelled to say by next year 2010-2011 fiscally if the going-down-everywhere continues at the present clip, then all bets-promises that Governor Steve Beshear made will have been 'off' about further-evisceration of (pertinent to my-folk) mental health. What is being proposed seems like 'creative accounting' that governments can actually accomplish-- here such as making next-year's Rainy-Day-Fund go for this one-- 'furloughs' of state workers [a proposed 3 days]-- and of course hikes in coal-severance and cigs.
I can only speak to the social sciences I know-- econ not included well-- demographics being in-the-mix of what I have studied. I had a great prof Dr. Michael Endres at (would-become) Northern Kentucky University to say that if one can understand social structure and social demographics one can fathom any social problem. To that I agree-- but would add that a fuller dimension is added with Verstehen of motivation-- really a social-psychology per exemplar Max Weber.
I know Kentucky pretty well-- this is a state which thus 'knowably' produces a great gusher of 'to-backer,' and is just about the highest-per-capita smoking venue in the country. Would all these smokers-- unfortunately including a lot of folks mental-healthed-- vote to make cigs more expensive than Yankee Indiana or Ohio??? And the coal thing has been a money-maker for Kentucky, 'King Coal' pays for the medical schools, invests in tech, bankrolls education via the Severance Tax; the predictable deal though is that King Coal expects things in some abundance to go their way-- like the E-Z dump solutions we have for fill into creeks-- and generally the history of this state is grim with memories of how Big Coal money is predisposed-to-predominance and predictable mischief. In hard-times how charitable will Coal be because (say) mental consumers are eating from dumpsters in Louisville??? Having worked in Kentucky gov as underling, I am aware when things get grim-- associated with deep-freeze in hiring & austerities as now-- as hearing of mysterious ways of keeping things afloat; now in this having done pinhead dancing during those threadbare times do wonder to-what-degree/how all this creative fiscality will derive.
I have been listening to the feeds from KET's "Kentucky Tonight" about the budget. This p.m. I heard the 1/5/2009 presentation of Bill Goodman including inter alia David Williams; just a few nights before that I heard the 12/15/2008 "Kentucky Tonight" which was on the same topic, with panelists including State Rep Jim Wayne, a Louisville social worker turned pol. Williams was not tossing away the idea of a cigarette-tax uppage -- but said cuts needed first Job 1 priority-- and at any rate in the current short session only a 'Super-Majority' [does this not mean 60%?] would be needed to vote something of the order Governor Beshear asked. Williams also said there had been slow-timing in getting the proposed budget fixes to General Assembly Republicans. There was verbalized fretting about what $$$ would be lost if folks out-of-state did not any longer come to KY to get 'backer products-- and this is a note familiar to cheap-smoking Kaintuck. In sum, I did not really get much great assurance that this would be a 'passer' there in Frankfort-on-Kentucky this time. The other Republicans in this talk were lukewarmish about maybe a fix with just 25 cents more on a pack of cigs.
The "Kentucky Tonight" featuring Jim Wayne I bring up because it has some keen data in his presentation. He referred in this 12/15/08 tele-talk that the poor of this state pay about a tithe (10%) of income for taxes; the upper-upper-uppers (we do have some really rich people here and there) pay about 5%. This knowing the level-of-deception practiced, 'Class-to-unclass' is not ultra-excessively surprising, and I assume there here to be more-truth than untruth. I would interpret it as the result of the facile way in which lower-lowers are ex-ed dys-ed out of the 'knowing' process-- and this can be done by generating we-they feuding over the minimum-wage-paupers evilly eying the disabled, the Medicares aghast at the goodies of Medicaid, and all that structural problematic. Put a few ads on the TV about raising-taxes and the minimumed-paupers will vote-em-out. Otherwise, with nobody down there fully aware of what-the-money-is, from-whence-it-comes, certainly to-whence-it-goes, there can be lots of trippy misdoing that will frequently convince the poorest that there is something evil about making-progressive and fair-square-honest about taxation.
And this structural problem seems intrinsic to 'the Kentucky Problem'-- a variant of the Cracker Southern problem-- that the really-vulnerable can readily be convinced by the have-everything-but-generosity-folk that somehow justice derives from getting mean with someone presumably lower. This used to more-include black folk, but now their income levels are getting up closer to the median national income here-- which is now $31 000 per year-- about twice mine (and that's OK.) Demogogues have always been pretty successful in beating-drum for some issue that plays-well-if-playing-well-in-the-Southern-Baptist-mindset here. Whether to post The 10 Commands... A scandal will be enough to get a pol's entire party evicted... Nowadays the 'kick-ees' can too include gay-rights-vote-downs to win elections for Democrats who even themselves disavow gay-marriage and other gaiety-- a sure winner for bringing-in any other kind of welfare-to-wealth in the next legislature. The Kentuckian has a true-sucker affinity for getting behind issues that are good-n-mean alright-- but net nothing to the greatest-good-for-the-greatest-number (meaning here in Dark & Bloody Land lots of Po' Lazaruses like me). In the pre-conclusion therefore, one might tend to think of these as ways that a small witting and cunning minority of haves can convince have-nots against really voting their wallets.
I cannot say that I am at all against the cig tax: REALLY I am for it. It just looks as though a lot of people/interests have 'dibs' on whatever derives from that-- greater good fortune for services if this is voted-in at $.70 per-- but that does not look like what this To-Backer State does when confronted with such to-backer pinching issues. We are a far cry from the time when tobacco was grown on every other farmlet in the Commonwealth, but I think the un-holiness of the alliance between tobacco-money remaining and the demographic of smokers still-pulses-blood-hot-as-Dog-Days here. If it does pass, it looks as though it will not be a structural solution-- just as my voicing support of extended gaming would likely bring in the-bucks for most of the fixes MH etc. says it wants-- but this too is a gimmicky, non-structural solution.
What seems to make the overall culture move-- when it does do so-- is NEWS. Then it may be that if/when there can be presentation which removes-blinders from the have-nots-- and NOTE here that I mean nothing like what a Stalinist means by 'revolutionary consciousness'-- then perchance these demogogeries will not sway, and folk can vote-wallet. If folk in Kentucky did this, with the heavy portion of impoverished here, it seems to me that there would be more light-at-tunnel's-end.
Mental health in all this has consistently been an 'orphan-child'-- by long time series viewed as a source of getting-jobs in the Commonwealth of some stability and 'goodness'-- weaker on the empiricism required for psychiatry as a scientific discipline-- and reliably in-human in its delivery of human-services with unvarying affirmation of kindness and gentleness to the 'poor lunatics put-away.' A structural solution of a back-hand sort has been my/our liberty from asylum. A means-motive-opportunity structure for practicing contribution to society would go a longer way toward taking away some of the orphan status. As an existentialist, this night I think I have portrayed an existence coming before this professed essence: to get there we shall have to assume that while Kaintuck no longer as much wants to put-us-away (too expensive!) so maybe with wiles and responsibility we can angle-- taxes or no-- to edgewise keep our liberty if not a hole-into-which-be-flopped when we die bitter death.
In fine, after having made all these permutations of read-fact, to be helpful I think I can try to keep the highest standard of journalism-- especially the standard of creative insight into this and other blogs I do. This is virtually a full-time job. On this budget issue, for example, the money is so big-- and the solutions for getting the required money patently so sub-dividedly little-- that I just can only promise to apply concentration and my best diligence to the topic. Tax-hikes are NOT something Kentuckians or citizens in democracies elsewhere like to accede-to. And the problem is from all perspectives seeming deeply cultural, embedded in the illusions that are the fabric of the pledged-allegiance of the Southern Code to which sickeningly we rather adhere-- as cutting off nose chin and brow in the process. So the mental-health of planfulness in depressed-times would seem to be my marching-orders, and I shall help (in this informative way which to me seems fundamental) as I write on, and live right-on.
--Vernon Lynn Stephens
D.S.M. IV-TR # 296.44
Wednesday, January 07, 2009
Tuesday, January 06, 2009
A Kind-Of Developing 'Pickle'-- FACE-THE-MUSIC!!!
Providers Now Asking 'Medicare Advantage'
With Me on Pauper-Medicare Income
Friends, I have reported on some Medicare tightnesses in my last entry; my primary reason for getting Medicare A & B-- hospitalization + doctor's-visits-to-theirs-- derives from my bipolar condition. Only PARTLY because bipolar disorder is one of the more-expensive-disabilities do these forboding-- but certainly undepressed-- thoughts pertain.
Nowadays, the repetitive request from the intake-folk at medical places is for (with me, my kind) Medicare Advantage linkage. You may know that Medicare Advantage is a supplemental insurance to Medicare, will get-ya just about the coverage seniors typically need in the elder-years (euphemistically speaking.)
I would like something like this because there are some 'nasties' in the way of frowns and somewhat irked voicing from these medical-ones at such times. Knowing what I do about the Budget Reduction Act of 2006, and what the American Medical Association says is going to happen for-sure sans reversal in the coming apocalypse of the 2010s and 2020s, 'unless something is done.' Never one to think that there would be very-much-if-any-action to pitch into my needs in a nice way-- seemingly corroborated by autobiograph-- I suppose that this single-payer-insurance talk (something like universal healthcare) will just be a fizz for me: I am not looking for any Saviors (besides the outa-the-box kinda Jesus-- can I say that??) to fixes-me-up when and if the time certainly will-come when I get something dire medically and suffer badly for it. Sure, if I could get something that would take-away-the-frowns of these receptionists at healthcare places-- maybe here something like Medicare Advantage-- OK.
But I just did a quick-check on Internet for Medicare Advantage programs in this area (Louisville, KY). All of these are operating on assumptions about the level of health one possesses. The FIRST REALITY PROHIBITING NICENESS -- OR PAYMENT-OF-PIPER-MEDICAL-- will have to be the pennies I have from bank OD many months. Also, one of the first considerations would be my assessed state of health-- if 'average' then a bill of $90 per month cheapo; if 'good' then $18+; if 'poor'-- and mentals with their expensivenesses (hospitalizations typically unwanted) will perenially be said to have 'poor' status here. I have not been hospitalized since 2001 {medical-necessity-questionable I then thought in what felt (from my bias) like a pretty raw deal vis a vis my anger at the main provider I had letting-go a Nurse-Practitioner} ...yet no matter, best said. Actually THERE'S NOT MONEY FOR ANY OF THESE LEVELS OF CHEAPISSMO MEDICALS. There is in this region a kind of Medicare Advantage if one has-worked-just-a-little-not-enough so's to get Medicaid for least-Medicare-- (yea including some who were never-working-from-rich-families) called "Passport"-- as I have worked with no bitterness I just have to concede that here too I am unqualified. So... Rack it up to Breaks, with Que sera sera as the childhood song of an Italianism runneth...
As I compute, I am just going to have to face crap-out, and this should be-- given the obesity of things-here, and the processed aging again here-- within the next 10 years. I keep saying this will be the inevitable hurt, and I just look for maximal hurts for no-money, and from the looks of it now no expectable best-practice for worker-I'd-been but indigent-- instead some business that will be 'papered' as really-super-duper nice humane stuff... licks and promises etc.
OK I repeat yet one more time. No sour grapes, but sometimes down on the grits-end of society some of the fun 'papery' services to which I allude are pretty lousy really-- cheapest=great none=best I say. IF something like professedly-nicey-nice does happen into me-- like much else on the bung-end of this Korn Likker Locus much augurs to have been double-talk/double-speak/duplicity. It is hard for me to imagine how I can therefore perform more-rationally than I am already-- staving off the BIG CRUNCH coming-- but with the certainty that that-will-be-kinda-just-deserts for the cleft/pidge-hole into which I have been pegged.
I certainly care about them-apples; but face it this is Louisville Kentucky USA and do not expect a single one to sincerely care in felt-ways about this coming Categoric Abyss. I do not think I shall do anything but say-thank-you and sorry-I-bothered-you and walk away when the inevitable time comes when Receptionist says (as instructed by the Boss fed up with the harrassment Medicare gives them) I am sorry Sir we can only take you if you have REAL health insurance, Medicare-Advantage or something.
That's what I have to do 'when my number's up' in this healthcare thingie. OK I say this one time more OK.
--Vernon Lynn Stephens
D.S.M. IV-TR # 296.44
M.S.S.W.
Providers Now Asking 'Medicare Advantage'
With Me on Pauper-Medicare Income
Friends, I have reported on some Medicare tightnesses in my last entry; my primary reason for getting Medicare A & B-- hospitalization + doctor's-visits-to-theirs-- derives from my bipolar condition. Only PARTLY because bipolar disorder is one of the more-expensive-disabilities do these forboding-- but certainly undepressed-- thoughts pertain.
Nowadays, the repetitive request from the intake-folk at medical places is for (with me, my kind) Medicare Advantage linkage. You may know that Medicare Advantage is a supplemental insurance to Medicare, will get-ya just about the coverage seniors typically need in the elder-years (euphemistically speaking.)
I would like something like this because there are some 'nasties' in the way of frowns and somewhat irked voicing from these medical-ones at such times. Knowing what I do about the Budget Reduction Act of 2006, and what the American Medical Association says is going to happen for-sure sans reversal in the coming apocalypse of the 2010s and 2020s, 'unless something is done.' Never one to think that there would be very-much-if-any-action to pitch into my needs in a nice way-- seemingly corroborated by autobiograph-- I suppose that this single-payer-insurance talk (something like universal healthcare) will just be a fizz for me: I am not looking for any Saviors (besides the outa-the-box kinda Jesus-- can I say that??) to fixes-me-up when and if the time certainly will-come when I get something dire medically and suffer badly for it. Sure, if I could get something that would take-away-the-frowns of these receptionists at healthcare places-- maybe here something like Medicare Advantage-- OK.
But I just did a quick-check on Internet for Medicare Advantage programs in this area (Louisville, KY). All of these are operating on assumptions about the level of health one possesses. The FIRST REALITY PROHIBITING NICENESS -- OR PAYMENT-OF-PIPER-MEDICAL-- will have to be the pennies I have from bank OD many months. Also, one of the first considerations would be my assessed state of health-- if 'average' then a bill of $90 per month cheapo; if 'good' then $18+; if 'poor'-- and mentals with their expensivenesses (hospitalizations typically unwanted) will perenially be said to have 'poor' status here. I have not been hospitalized since 2001 {medical-necessity-questionable I then thought in what felt (from my bias) like a pretty raw deal vis a vis my anger at the main provider I had letting-go a Nurse-Practitioner} ...yet no matter, best said. Actually THERE'S NOT MONEY FOR ANY OF THESE LEVELS OF CHEAPISSMO MEDICALS. There is in this region a kind of Medicare Advantage if one has-worked-just-a-little-not-enough so's to get Medicaid for least-Medicare-- (yea including some who were never-working-from-rich-families) called "Passport"-- as I have worked with no bitterness I just have to concede that here too I am unqualified. So... Rack it up to Breaks, with Que sera sera as the childhood song of an Italianism runneth...
As I compute, I am just going to have to face crap-out, and this should be-- given the obesity of things-here, and the processed aging again here-- within the next 10 years. I keep saying this will be the inevitable hurt, and I just look for maximal hurts for no-money, and from the looks of it now no expectable best-practice for worker-I'd-been but indigent-- instead some business that will be 'papered' as really-super-duper nice humane stuff... licks and promises etc.
OK I repeat yet one more time. No sour grapes, but sometimes down on the grits-end of society some of the fun 'papery' services to which I allude are pretty lousy really-- cheapest=great none=best I say. IF something like professedly-nicey-nice does happen into me-- like much else on the bung-end of this Korn Likker Locus much augurs to have been double-talk/double-speak/duplicity. It is hard for me to imagine how I can therefore perform more-rationally than I am already-- staving off the BIG CRUNCH coming-- but with the certainty that that-will-be-kinda-just-deserts for the cleft/pidge-hole into which I have been pegged.
I certainly care about them-apples; but face it this is Louisville Kentucky USA and do not expect a single one to sincerely care in felt-ways about this coming Categoric Abyss. I do not think I shall do anything but say-thank-you and sorry-I-bothered-you and walk away when the inevitable time comes when Receptionist says (as instructed by the Boss fed up with the harrassment Medicare gives them) I am sorry Sir we can only take you if you have REAL health insurance, Medicare-Advantage or something.
That's what I have to do 'when my number's up' in this healthcare thingie. OK I say this one time more OK.
--Vernon Lynn Stephens
D.S.M. IV-TR # 296.44
M.S.S.W.
GOLDEN OPPORTUNITY!!!
Medicare Does Random Review
Of a Portion of My Medical Record
(i.e. Glucometric Readings)
For some time, I have been hoping for ways to realistically tell the-feds about the is-ness of my medicalities of which the medical economics of Medicare is a living part. It may be just coincidental to taking the 'fatteners' notorious as psychotropics/mood-stabilizers that I have diabetes-- but the total person is the phenotype hypothetically interesting to Medicare-- or any auditor interested in empiric evidence -- as opposed to bookkeeping (which can be trumped-up and is so-trumped all the time by the liars in healthcare provision.) Thus I have lots of records about my diabetic condition-- from the prodromal weight gain (I have said subsequent-to-what previously and need not repeat) to the visitation to the endrocrinologist, who when some management was effected for [psycho-social-] medical economies referred me to my [great!] GP for supervision. Thus, along with Cognizance, and MMSEs, and galvanic-skin-response measures, I have a huge trove of glucometric readings.
What Medicare has selected me for-- random review of my glucometer reads-- is just like every kind of recording done here with the assumption that just-me-Vernon's the only one who needeth the info. Most days are filled in. Some days-- almost always unless there is some derailment in my schedule (this likeliest happens around the 'third of the month payday-seasonal')-- there is a 'miss'/hole in the data-- and most-frequently I call that a 'hiatus'-- and sometimes I do not. It DOES TOO usually mean that I do a gluco-reading then, just do not record the measure-- which in habitude is 'the evil necessity' of empiricism-- but certainly one I always did disdain and as SW was-not-hyper-good-at.
Anywho, I am kinda hoping that Medicare lets me go full-force with this-- and tries to get to something that is a little more user-friendly or at least true-to-the-real-world. For example, somewhere it got stuck into my provider's test-strip record that I meter 3X per day-- whereas I recall a spell in September 2008 when thrice-daily metering was essential-- the glucose tolerance curve was going down with stubborn tardiness (a CERTAIN sign one IS diabetic)-- and it became that (1) I made arrangements to get test-strips for thrice-daily reads-- essential then, sometimes essential now; (2) started the practice-- when metering (almost all days)-- of eating IFF my blood-glucose was ~ 95 (just below too high.) Some days I indeed might need 3X of gluco readings, other days-- now with some better feed-back sense of when I am 'ready' to eat (generally showing as really-really-strong-hungers)-- the '~95 rule' is getting easier and more-accurate to apply/practice.
There is one more important consideration: at the beginning of each year, each Medicare recipient (I think this does not apply to Medicaid folk, who hypothetically never worked)-- there is a period when one must pay 100% of medical expenses. Most people try hard to get medicalities into the tail-end of the year, which is in universal-holiday-time frequently no small challenge. I DID TOO level with the provider of my glucometer test strips that I MAY indeed use perchance 3 test-strips per day-- but one strong incentive would be to have a good supply for waiting out the period until Medicare 'gets-good'/pays for healthcare. In 2008, I had to do without ANY glucometrics for a period of about a month-- NOT FOLLOWING BY THE RULES-- but 'twas all my wallet-could-do. This year, I seem to be being watched for random review (don't know what connection that has with auditing probably zero) on this test strip thing.
I do NOT feel as though this is any-outa-ordinarity-- but there are 'papery' ways to do bookkeeping, and 'empiric' ways-- and IF the presenter of facts has in a natural-world arrangement 'books that are too clean' then I would have to suspect the sneaky kind of oversight that makes slam-dunk program-evals etc.-- TOO GOOD IS SIMPLY AN INDICATION OF DISHONESTY. My 'books' for which the feds wanna look are just 'pretty good'-- I'd say about at the 80th percentile of diligence-- and the more-or-less-managed diabetes does require glucometry strips 'scripts and all.
Lots of Medicare recips are cognizant of the crisis-- the make/break time of like January of a New Year-- when 'you're on yer own' fiscally. It does mean that for the luckless or the sufficiently-indigent there may be a certain doing-without medicine until the $100 deductable (don't know what 'tis in 2009) gets paid fully. Lots of diabetics too know about metering-for-the-time-to-eat-- which may be done sometimes once a day, may sometimes require 3-4X per day. IFF Medicare is health insurance, they may realize that the physiology of need may not correspond exactly to the account-book-makers-recording-purpose. I want to see therefore what Medicare will do with the presentation of TOTALLY HONEST DATA-- here glucometry-- to see whether sometimes 3X metering is required, sometimes 1X, and occasional real times when I am too-busy-to-'chart' or really betimes too-busy-to-be-busied-busywork-wise.
THIS of course is a mental health Web-log/blog. What sounds peculiarly medical tonight (10 p EST 1/6/09) is when one considers the Total-Perspective relevant to MH-- for I suggest again that I GOT this diabetes (& hypertension & obesity & orthopedics etc.) status post compliance to medication (the psychotropics and mood-stablizers to which I allude.) Here there was never seemingly any oversight to the MH pros who repeatedly indicated that they were essentially ONLY interested in my compliance to 'head-meds'-- Medicare never ever that I ever heard said Boo to a shrink who would not say that LIKELIEST one would get obese with these psychopharmaceuticals-- something known as METABOLIC SYNDROME DISORDER-- from which yer diabetes/'sugar' hypertension fatness and orthopedic mishaps seem tellingly/compellingly to derive. NO: psychiatry seems to have gotten a 'free ride' through all this seeming fattening-for-killing. It means that Medicare is concerned about test-strips and 'script exactitudes for like metformin (diabetes meds) and not-exactly-concerned at all detectably about METABOLIC SYNDROME where it rather too frequently to my assay occurs-- in 'us' the mental health consumers.
The essential irrationality of this situation seems apparent: there is some E-Z grading of psychiatry for its heavy use of heavy-making chemo, HARD grading about best-practice for bipolars (which includes provably supportive/cognitive psychotherapy as well as mood-stabilizing chemotherapy). Medicare has yet to say 'diddle' about the hog-fattened-psychiatry patients produced by the profession, but BOY count the pennies centillas when/if the gal/guy so sapped gets like hypertension, bad-knee-from-obesity-syndrome, or-- as here-- hard-to-control-glycemia-diabetes. This looks like a 'free ride' for the chemists in MH, a hard ride for self-management-teaching helpers, and free-expensive psychosocial medical crises-- well known to generate dysthymia in all so why not bipolars???-- with the pinch:penny:time all MH folk on Medicare (as all therein) about this time of year.
I hope I am AUDITED from lovey-dovey Medicare. But I hope this means an HONEST EMPIRIC AUDIT-- with a focus on what-is-- an honest screamy-honest-person-as-possible trying to do the-hurdle of some crisis proportions now-- with recognition that all this stuff medicine seems contributory to causing needs medical attention (psychiatric and non-psychiatric)-- STARTING WITH REAL HEALTH INSURANCE!!!!
--Vernon Lynn Stephens
D.S.M. IV-TR # 296.44
M.S.S.W.
Medicare Does Random Review
Of a Portion of My Medical Record
(i.e. Glucometric Readings)
For some time, I have been hoping for ways to realistically tell the-feds about the is-ness of my medicalities of which the medical economics of Medicare is a living part. It may be just coincidental to taking the 'fatteners' notorious as psychotropics/mood-stabilizers that I have diabetes-- but the total person is the phenotype hypothetically interesting to Medicare-- or any auditor interested in empiric evidence -- as opposed to bookkeeping (which can be trumped-up and is so-trumped all the time by the liars in healthcare provision.) Thus I have lots of records about my diabetic condition-- from the prodromal weight gain (I have said subsequent-to-what previously and need not repeat) to the visitation to the endrocrinologist, who when some management was effected for [psycho-social-] medical economies referred me to my [great!] GP for supervision. Thus, along with Cognizance, and MMSEs, and galvanic-skin-response measures, I have a huge trove of glucometric readings.
What Medicare has selected me for-- random review of my glucometer reads-- is just like every kind of recording done here with the assumption that just-me-Vernon's the only one who needeth the info. Most days are filled in. Some days-- almost always unless there is some derailment in my schedule (this likeliest happens around the 'third of the month payday-seasonal')-- there is a 'miss'/hole in the data-- and most-frequently I call that a 'hiatus'-- and sometimes I do not. It DOES TOO usually mean that I do a gluco-reading then, just do not record the measure-- which in habitude is 'the evil necessity' of empiricism-- but certainly one I always did disdain and as SW was-not-hyper-good-at.
Anywho, I am kinda hoping that Medicare lets me go full-force with this-- and tries to get to something that is a little more user-friendly or at least true-to-the-real-world. For example, somewhere it got stuck into my provider's test-strip record that I meter 3X per day-- whereas I recall a spell in September 2008 when thrice-daily metering was essential-- the glucose tolerance curve was going down with stubborn tardiness (a CERTAIN sign one IS diabetic)-- and it became that (1) I made arrangements to get test-strips for thrice-daily reads-- essential then, sometimes essential now; (2) started the practice-- when metering (almost all days)-- of eating IFF my blood-glucose was ~ 95 (just below too high.) Some days I indeed might need 3X of gluco readings, other days-- now with some better feed-back sense of when I am 'ready' to eat (generally showing as really-really-strong-hungers)-- the '~95 rule' is getting easier and more-accurate to apply/practice.
There is one more important consideration: at the beginning of each year, each Medicare recipient (I think this does not apply to Medicaid folk, who hypothetically never worked)-- there is a period when one must pay 100% of medical expenses. Most people try hard to get medicalities into the tail-end of the year, which is in universal-holiday-time frequently no small challenge. I DID TOO level with the provider of my glucometer test strips that I MAY indeed use perchance 3 test-strips per day-- but one strong incentive would be to have a good supply for waiting out the period until Medicare 'gets-good'/pays for healthcare. In 2008, I had to do without ANY glucometrics for a period of about a month-- NOT FOLLOWING BY THE RULES-- but 'twas all my wallet-could-do. This year, I seem to be being watched for random review (don't know what connection that has with auditing probably zero) on this test strip thing.
I do NOT feel as though this is any-outa-ordinarity-- but there are 'papery' ways to do bookkeeping, and 'empiric' ways-- and IF the presenter of facts has in a natural-world arrangement 'books that are too clean' then I would have to suspect the sneaky kind of oversight that makes slam-dunk program-evals etc.-- TOO GOOD IS SIMPLY AN INDICATION OF DISHONESTY. My 'books' for which the feds wanna look are just 'pretty good'-- I'd say about at the 80th percentile of diligence-- and the more-or-less-managed diabetes does require glucometry strips 'scripts and all.
Lots of Medicare recips are cognizant of the crisis-- the make/break time of like January of a New Year-- when 'you're on yer own' fiscally. It does mean that for the luckless or the sufficiently-indigent there may be a certain doing-without medicine until the $100 deductable (don't know what 'tis in 2009) gets paid fully. Lots of diabetics too know about metering-for-the-time-to-eat-- which may be done sometimes once a day, may sometimes require 3-4X per day. IFF Medicare is health insurance, they may realize that the physiology of need may not correspond exactly to the account-book-makers-recording-purpose. I want to see therefore what Medicare will do with the presentation of TOTALLY HONEST DATA-- here glucometry-- to see whether sometimes 3X metering is required, sometimes 1X, and occasional real times when I am too-busy-to-'chart' or really betimes too-busy-to-be-busied-busywork-wise.
THIS of course is a mental health Web-log/blog. What sounds peculiarly medical tonight (10 p EST 1/6/09) is when one considers the Total-Perspective relevant to MH-- for I suggest again that I GOT this diabetes (& hypertension & obesity & orthopedics etc.) status post compliance to medication (the psychotropics and mood-stablizers to which I allude.) Here there was never seemingly any oversight to the MH pros who repeatedly indicated that they were essentially ONLY interested in my compliance to 'head-meds'-- Medicare never ever that I ever heard said Boo to a shrink who would not say that LIKELIEST one would get obese with these psychopharmaceuticals-- something known as METABOLIC SYNDROME DISORDER-- from which yer diabetes/'sugar' hypertension fatness and orthopedic mishaps seem tellingly/compellingly to derive. NO: psychiatry seems to have gotten a 'free ride' through all this seeming fattening-for-killing. It means that Medicare is concerned about test-strips and 'script exactitudes for like metformin (diabetes meds) and not-exactly-concerned at all detectably about METABOLIC SYNDROME where it rather too frequently to my assay occurs-- in 'us' the mental health consumers.
The essential irrationality of this situation seems apparent: there is some E-Z grading of psychiatry for its heavy use of heavy-making chemo, HARD grading about best-practice for bipolars (which includes provably supportive/cognitive psychotherapy as well as mood-stabilizing chemotherapy). Medicare has yet to say 'diddle' about the hog-fattened-psychiatry patients produced by the profession, but BOY count the pennies centillas when/if the gal/guy so sapped gets like hypertension, bad-knee-from-obesity-syndrome, or-- as here-- hard-to-control-glycemia-diabetes. This looks like a 'free ride' for the chemists in MH, a hard ride for self-management-teaching helpers, and free-expensive psychosocial medical crises-- well known to generate dysthymia in all so why not bipolars???-- with the pinch:penny:time all MH folk on Medicare (as all therein) about this time of year.
I hope I am AUDITED from lovey-dovey Medicare. But I hope this means an HONEST EMPIRIC AUDIT-- with a focus on what-is-- an honest screamy-honest-person-as-possible trying to do the-hurdle of some crisis proportions now-- with recognition that all this stuff medicine seems contributory to causing needs medical attention (psychiatric and non-psychiatric)-- STARTING WITH REAL HEALTH INSURANCE!!!!
--Vernon Lynn Stephens
D.S.M. IV-TR # 296.44
M.S.S.W.
Monday, January 05, 2009
[Fixable!!] Disconcertion
Re a MH Consumer/Survivor Website
Let me explain: I try to be extremely cautious with my PC about that to which I 'link'-- owing to much bitter experience that this can be ruinous in myriad ways.
...But anyhow the federal government (USA) and I will even say with SAMHSA has a site online for the affairs of MH 'consumers/survivors'-- and as far as I have any knowledge is just fine as a 'trustworthy secure Website' for linkage.
This agency plans to fete some OK looking conference at the Ritz in Philadelphia in February-- no problems at all but with my independently-broke/pauper status impossible to attend-- and wondering if this had archives of videographic/audio-transcript, I attempted to connect. The PROBLEM was that both Mozilla Firefox and Microsoft were telling me-- for the first-time-ever that this would be a horrifically not-secure linkage-permission, and in BOTH Firefox and Microsoft NOT AT ALL recommended. Thus rather rattled by this odd contiguity-- a .gov site for health (mental) regarded almost singly of all sites as NOT RECOMMENDED NOT SECURE of all to which I've connected just made me WANT TO GET OUT-- so I dis-connected.
I am no supernaturalist in the sense that I believe that there are spooky-actions-at-a-distance (the Einstein definition of quantum science) which I can witness. Nor am I inclined to think there can be anything really bad about a .gov site. I just do think that if Microsoft and Firefox drop such notice on me, I had better heed, heed well.
Explanation?? Only hypotheses come to mind. There is something in epidemiology-- the collection of [healthcare pivotally] information about-the-people [Greek: epi -- 'upon, above, about'; demos -- 'the folk, people'] via which there can be surveillance-- a way for public health officials to keep-track of what goes on in manifestations of public behavior that impacts health. One of the best such Websites is said to be housed geographically in Canada; I think the federal government in Washington must certainly have such 'data mining/trawling' ops too. The 'Constititutionality' which may be suspect to Firefox and Microsoft in the business I encountered-- and about which I was simply too timid to attempt experiment-- really derives from the Preamble under the 'General Welfare' cause which means (and rather restrictively means) that a Police-Power can protect communities in the American venue-- and since the Roosevelt2 Era this has been the Police Power to effect Welfare in the welfare-enough sense (albeit there is no 'right' to welfare as known)-- and permit surveillance of the health behaviors to which I refer.
I am just going to kick-back somewhat until I find out for sure whether this site is as secure as it must be to be .gov. Nothing makes me think anything sinister or Big-Bro-Watches or anything. But in terms of 'consumer psychology,' IF the feds know that this site will present consumers (who occasionally get pretty distraught about this government-watching thing) then there is a problem in the management of the stuff that puts it online, and about this I think the folks-- at SAMHSA is all I'll say-- need to think about this-- and kinda 'retool' if it looks like this 'freaks out' the intended audience (like me for all the gore I have associated with over-trust in computer/Internet things.)
--Vernon Lynn Stephens
D.S.M. IV-TR # 296.44
M.S.S.W.
Re a MH Consumer/Survivor Website
Let me explain: I try to be extremely cautious with my PC about that to which I 'link'-- owing to much bitter experience that this can be ruinous in myriad ways.
...But anyhow the federal government (USA) and I will even say with SAMHSA has a site online for the affairs of MH 'consumers/survivors'-- and as far as I have any knowledge is just fine as a 'trustworthy secure Website' for linkage.
This agency plans to fete some OK looking conference at the Ritz in Philadelphia in February-- no problems at all but with my independently-broke/pauper status impossible to attend-- and wondering if this had archives of videographic/audio-transcript, I attempted to connect. The PROBLEM was that both Mozilla Firefox and Microsoft were telling me-- for the first-time-ever that this would be a horrifically not-secure linkage-permission, and in BOTH Firefox and Microsoft NOT AT ALL recommended. Thus rather rattled by this odd contiguity-- a .gov site for health (mental) regarded almost singly of all sites as NOT RECOMMENDED NOT SECURE of all to which I've connected just made me WANT TO GET OUT-- so I dis-connected.
I am no supernaturalist in the sense that I believe that there are spooky-actions-at-a-distance (the Einstein definition of quantum science) which I can witness. Nor am I inclined to think there can be anything really bad about a .gov site. I just do think that if Microsoft and Firefox drop such notice on me, I had better heed, heed well.
Explanation?? Only hypotheses come to mind. There is something in epidemiology-- the collection of [healthcare pivotally] information about-the-people [Greek: epi -- 'upon, above, about'; demos -- 'the folk, people'] via which there can be surveillance-- a way for public health officials to keep-track of what goes on in manifestations of public behavior that impacts health. One of the best such Websites is said to be housed geographically in Canada; I think the federal government in Washington must certainly have such 'data mining/trawling' ops too. The 'Constititutionality' which may be suspect to Firefox and Microsoft in the business I encountered-- and about which I was simply too timid to attempt experiment-- really derives from the Preamble under the 'General Welfare' cause which means (and rather restrictively means) that a Police-Power can protect communities in the American venue-- and since the Roosevelt2 Era this has been the Police Power to effect Welfare in the welfare-enough sense (albeit there is no 'right' to welfare as known)-- and permit surveillance of the health behaviors to which I refer.
I am just going to kick-back somewhat until I find out for sure whether this site is as secure as it must be to be .gov. Nothing makes me think anything sinister or Big-Bro-Watches or anything. But in terms of 'consumer psychology,' IF the feds know that this site will present consumers (who occasionally get pretty distraught about this government-watching thing) then there is a problem in the management of the stuff that puts it online, and about this I think the folks-- at SAMHSA is all I'll say-- need to think about this-- and kinda 'retool' if it looks like this 'freaks out' the intended audience (like me for all the gore I have associated with over-trust in computer/Internet things.)
--Vernon Lynn Stephens
D.S.M. IV-TR # 296.44
M.S.S.W.
Saturday, January 03, 2009
Telling a Telling Social Fiction:
A Rich Joke about Mental Health
In Recovery
There used to be a genre of lit called 'social fiction'-- which in this country approximately began with Upton Sinclair went through the Dreiser time to John Steinbeck, dying deadly I think with the suburbanite Winter of Our Discontent (Steinbeck, 1961.) Let me aspire to resurrect a little of this social fiction for just cause-- for the just cause of disenfranchised Kentucky mental-health-consumers/patient-patients-- and utter some farce whose parable is True-as-Hell (as yea life-is-Hell.)
Suppose a story with a Beginning Middle and End (the Aristotelian best practice) corresponding to the Antecedent Behavior Consequence (ABC) of applied behavior analysis in some parabolic, thus true as Hell way to take heart.
Fancy a Fancy One M/F from a 'well to do' Family (always one leg up in the world, particularly in the Kaintuck Korn Likker Aristocracy). What happens when class-gets-crazy?? Prone to pout, prone to the Prima Don/Donna gambit of my-side/their-side internecine politicing, prone to parental partiality-- whatever D.S.M. coding such a one would have would be many times more more more to class and culture here than say the garbage-eating Untouchable Mentally Ill I see around here, where jail is the kind and usual mental health betimes. No... such a Don/Donna does go to the best places, the Tufts Medicals the Good Shep Pratts and the Menningerisms you know the creme de la creme the richies get for their kind and usual MH... and thereupon flops into ownership in Herod's Pilate Creek, thus makes big in Lousyville; never working this Don/Donna does get [as disabled] SSI and Medicaid and thus gets the treats-- all of them-- incumbent to those whom Lyndon Johnson called 'the poor Mammys with their babies'-- which is really the BEST health and the best insurance for the ones-getting-it, living in Herod's Pilate Creek no matter.
Where then does the Don/Donna go? To the top, patently. Newspapers find on his/her photogenic qualities a poster-child; the media make movies of this pictured-one-- who may just have vegetated where there is plenty of potential for vegetation, places to play, piddle, pretend; but when the photo op and movie-making comes-- magic makes missionary-medicine!!! Now Don/Donna HEALS-- the better to boot the caretakers the better to boon your blessed and benefitted kinds into MH that is hard-to-reach hard-to-find hard-to-know-about but always now asking-hard for the hard money taxes for some repute of doing-better. What proof? Not the usual hydrochloric evals to which the social agencies who do anything like the business-end of mental-health/psychiatry have to do-- the size effect of thousands, all benefitted to the 3s.d./99%-ile-- but no nothing but ask me no questions tell you no lies.
Has this ever happened in mental health, in Kentucky mental health? If it happened once, then shame on Kentucky!!! But let us say a further damning fiction-- that numbers and numbers of these plush ones in their way 'do what comes to mind' according to the Ole Kentucky Home Remedy for social-promotion/advancement-- called here PULL. And there will have been pull-- and push-- for such privilege to do its usual kind-and-usual WPA ('we piddle around') while the garbage-eaters go on eating garbage in Lousyville, or perhaps on an Alberta-Clipper/Artic/10-degree night get kind and usual jail (overnight, sometimes overyear.) The garbage-eaters certainly know naught of the club of cozy consumers over in the suburbs-- for $10 per hour proving they can 'do it more cost effectively' than the other kind and usuals. The presumption is of course that the cozy consumers are indeed doing it, that they are known in their hide-outs to the easily-jailed in the so-called Hell of Justice places-- and maybe I shall pass on that fiction to a structural narrative-paradigm (holding true for all narratives, I am told, by discourse-analysis.)
ANTECEDENT: The 'measles' of some D.S.M. state-- of which diagnosis can be superduper easy to obtain. A period of rich and fattened vegetation. Then: job-opportunity: the Brass seeing your 'good family' and photogenic qualities, boost you to promise of power glory fame-- IFF you say naught but good things about 'our program.'
BEHAVIOR: Miraculous cure! Call it 'healing' call it 'got-well' call it 'totally recovered.' Then out to the TV cameras, where them movies and pressings and reportings roll on, roll on, roll on. Nothing but BAD THINGS said about the helpers-of-garbage-eaters, nothing but bad said of the garbage-eaters themselves. ALWAYS plug $$$$ for the agency WPA that boosted you into such photo op social promo, get a 'fair and balanced' (TM) Fox report on the miracles you/yours do-- damn the working-alternatives!
CONSEQUENCE(S): Like wetting the bed, it is warm for you for awhile: then the Chill. The social promos dry up-- especially IFF you dare cross-hair-sideways of some 501.c3 lobby that promotes its own, and out-cold otherwise. Soon the 'fair and balanced' (TM) folk want new faces for photo-op; try as you will, scream cry have-a-pee-potty-temper-tantrum no photo ops any longer.
DOES THIS EVER HAPPEN? DOES THIS EVER HAPPEN IN KAINTUCK?? Ask me no questions, will tell only the lie of the majority of times in which social promotion of the promoted societally might occur. Otherwise, with this lame social fiction, and the truth out there, I shall now drift into the silence of this Hermitage.
--Vernon Lynn Stephens
D.S.M. IV-TR # 296.44
M.S.S.W.
A Rich Joke about Mental Health
In Recovery
There used to be a genre of lit called 'social fiction'-- which in this country approximately began with Upton Sinclair went through the Dreiser time to John Steinbeck, dying deadly I think with the suburbanite Winter of Our Discontent (Steinbeck, 1961.) Let me aspire to resurrect a little of this social fiction for just cause-- for the just cause of disenfranchised Kentucky mental-health-consumers/patient-patients-- and utter some farce whose parable is True-as-Hell (as yea life-is-Hell.)
Suppose a story with a Beginning Middle and End (the Aristotelian best practice) corresponding to the Antecedent Behavior Consequence (ABC) of applied behavior analysis in some parabolic, thus true as Hell way to take heart.
Fancy a Fancy One M/F from a 'well to do' Family (always one leg up in the world, particularly in the Kaintuck Korn Likker Aristocracy). What happens when class-gets-crazy?? Prone to pout, prone to the Prima Don/Donna gambit of my-side/their-side internecine politicing, prone to parental partiality-- whatever D.S.M. coding such a one would have would be many times more more more to class and culture here than say the garbage-eating Untouchable Mentally Ill I see around here, where jail is the kind and usual mental health betimes. No... such a Don/Donna does go to the best places, the Tufts Medicals the Good Shep Pratts and the Menningerisms you know the creme de la creme the richies get for their kind and usual MH... and thereupon flops into ownership in Herod's Pilate Creek, thus makes big in Lousyville; never working this Don/Donna does get [as disabled] SSI and Medicaid and thus gets the treats-- all of them-- incumbent to those whom Lyndon Johnson called 'the poor Mammys with their babies'-- which is really the BEST health and the best insurance for the ones-getting-it, living in Herod's Pilate Creek no matter.
Where then does the Don/Donna go? To the top, patently. Newspapers find on his/her photogenic qualities a poster-child; the media make movies of this pictured-one-- who may just have vegetated where there is plenty of potential for vegetation, places to play, piddle, pretend; but when the photo op and movie-making comes-- magic makes missionary-medicine!!! Now Don/Donna HEALS-- the better to boot the caretakers the better to boon your blessed and benefitted kinds into MH that is hard-to-reach hard-to-find hard-to-know-about but always now asking-hard for the hard money taxes for some repute of doing-better. What proof? Not the usual hydrochloric evals to which the social agencies who do anything like the business-end of mental-health/psychiatry have to do-- the size effect of thousands, all benefitted to the 3s.d./99%-ile-- but no nothing but ask me no questions tell you no lies.
Has this ever happened in mental health, in Kentucky mental health? If it happened once, then shame on Kentucky!!! But let us say a further damning fiction-- that numbers and numbers of these plush ones in their way 'do what comes to mind' according to the Ole Kentucky Home Remedy for social-promotion/advancement-- called here PULL. And there will have been pull-- and push-- for such privilege to do its usual kind-and-usual WPA ('we piddle around') while the garbage-eaters go on eating garbage in Lousyville, or perhaps on an Alberta-Clipper/Artic/10-degree night get kind and usual jail (overnight, sometimes overyear.) The garbage-eaters certainly know naught of the club of cozy consumers over in the suburbs-- for $10 per hour proving they can 'do it more cost effectively' than the other kind and usuals. The presumption is of course that the cozy consumers are indeed doing it, that they are known in their hide-outs to the easily-jailed in the so-called Hell of Justice places-- and maybe I shall pass on that fiction to a structural narrative-paradigm (holding true for all narratives, I am told, by discourse-analysis.)
ANTECEDENT: The 'measles' of some D.S.M. state-- of which diagnosis can be superduper easy to obtain. A period of rich and fattened vegetation. Then: job-opportunity: the Brass seeing your 'good family' and photogenic qualities, boost you to promise of power glory fame-- IFF you say naught but good things about 'our program.'
BEHAVIOR: Miraculous cure! Call it 'healing' call it 'got-well' call it 'totally recovered.' Then out to the TV cameras, where them movies and pressings and reportings roll on, roll on, roll on. Nothing but BAD THINGS said about the helpers-of-garbage-eaters, nothing but bad said of the garbage-eaters themselves. ALWAYS plug $$$$ for the agency WPA that boosted you into such photo op social promo, get a 'fair and balanced' (TM) Fox report on the miracles you/yours do-- damn the working-alternatives!
CONSEQUENCE(S): Like wetting the bed, it is warm for you for awhile: then the Chill. The social promos dry up-- especially IFF you dare cross-hair-sideways of some 501.c3 lobby that promotes its own, and out-cold otherwise. Soon the 'fair and balanced' (TM) folk want new faces for photo-op; try as you will, scream cry have-a-pee-potty-temper-tantrum no photo ops any longer.
DOES THIS EVER HAPPEN? DOES THIS EVER HAPPEN IN KAINTUCK?? Ask me no questions, will tell only the lie of the majority of times in which social promotion of the promoted societally might occur. Otherwise, with this lame social fiction, and the truth out there, I shall now drift into the silence of this Hermitage.
--Vernon Lynn Stephens
D.S.M. IV-TR # 296.44
M.S.S.W.
Thursday, January 01, 2009
??? Peer-Specialization in MH
As An-Aging/Stressing-Process???
??? MH-Consumer-Leadership
As Being-Led-Around???
I had good occasion to luncheon with a mover-shaker-of-last-year in the Commonwealth's fledgling consumer movement (in MH that is); this shy one had been in helping services professionally just prior to her understandable fling into peer-services, fathomable for getting a paycheck on the mercenary predictably human end, fathomable for her-kind ('wounded healer,' formerly impaired-professional-- yet even as most consumers desiring to please-people/'help.')
From 2007 to 2008, this pretty lady had emphatically grayed in hair; she was noticeably wrinkled more-the-more (and things like this a gentleman of Southern last will hint not a peep to Belle!) She dropped a strongish suggestion that 'I do not plan to live a year longer now' and I suppose the witting reader might imagine things about this abbreviation-plan as I did.
And I happened to see what kind of reception she got-- who mattered to me most for being the kindest in the coterie there-- with frownies and veiled utterance that somehow her interactions were 'disorganized' (when in fact she did appear organized OK indeed-- and that would mean solid content maybe not with W Churchill rhetoric but fine.)
Seeing this, my mind went back to KYMAP time... some perhaps 5 years ago, when after a hard stint this N.P. led 'consumer-group' went through a drone about how-ya-oughta-take-yer-meds-take-yer-meds-take-yer-meds ilk identical to medication-groups familiar to all consumers hospitalized between 1975-2005-- THEN to something called PACE (Patient Assistance in a Community Existence) which per-its-Web-press read great to me, but WHEN I read the standard-operating-policy&procedures-book Recovery Guide to read such counter-evidenced-overweeningly gems as "Self-managed care is the set of skills for managing severe emotional states without the use of medication" (page 8--may be true only to the degree that the inaugural pathology is not destined-severe I'd say) "Unfortunately, the medical model absolves people of all responsibility for their problems and solutions" (page 9--nearly 98% counter-factual in my experience-- with its many 'reality therapies') there comes a success-story of a MH consumer who so "dealt with the distress at home, without medication" (page 31-- a thin-ice condition no-no to virtually any consumer or MH pro-- ask!) and a jewel of mis-information about the dopamine hypothesis (presumably of schizophrenia) on last-print-page "Mental illness is the loss of dreams, not the loss of dopamine" (as the dopamine-hypothesis of schizophrenia posits a surfeit of inter-synaptic dopamine, whereas Parkinson's Disease-- strictly neuro-- comes from dopamine-dearth.)
It jerked me reading this startling stuff-- I repeat completely turnabout from the modeling from TXMAP of Texas' hyper-compliance-to-professionals-oriented-reading required of us 'leaders' (??? Really who led but the pro med-group leader just like the hospital-ways-- the N.P. of course!!!) SO I said to FearlessFactual NP Leader: " _______ , I regret that I cannot as anticipated support my teaching of PACE-- as it is full of dangerous-for-consumers counter-factual information-- AND IN NUMEROUS WAYS CONTRADICTS THE INTENT OF KYMAP SO VIGOROUSLY AS TO FARSIFY." Response: OK, like good-bye.
So like good-bye to the conscientious-objector. Now the Sweeties still calling this KYMAP sent me a Christmas card, and from it I surmised that about the same old crowd was there in the group-- the paid-members who were to tell-their-story-again-again just like other members unpaid indeed just like group-participants in all group psychotherapies everywhere I know-- but for $12 an hour (I think that's the wage) one hour per week.
This prior experience goodbye of mine and the good-bying I was beginning to witness toward this prematurely aging once pretty-girl she was then leads me to wonder-strongly about the kind of social-envirions the general lot of peer-specialist/MH-consumer-leadership-so-called really might be in the general aggregate. My IMPRESSION-- corroborating with mounting experience-- would be that in a way completely as arbitrary:capricious:thin-ice as dishwashing janitoring (to some lesser extent) Goodwill-working THIS TYPE OF CONSUMER-PEER LEADERSHIP POSITION FOR SOME (say the impecunious) WOULD LACK THE SECURITIES THAT ARE VITAL TO ALL, YES TOO VIGOROUSLY FOR THE MENTAL-PROS I BOTH KNOW AND HAVE-BEEN.
It is becoming well-recognized that the American System of employment-- 'Master & Servant law' unchanged from medievals save for abolition of slavery/involuntary-servitude (13 Amend. U.S. Const.)-- is POISON for the welfare health longevity of its under-participants (but better for the privileged Bosses!) From what I can tell, this paradigm is exactly what-works/operates in the ifffffy business of MH consumer-leadership. For further example, I can point to the case of a woman H___ who was 'hired' by another advocacy-consumer-spin-off in Kaintuck one December, but had a death-in-family-could-she-grieve-come-in-2-weeks-hence??? Nah, H____ was obviously showing bad work attitudes to our-thing!!!! When later a witting MH consumer at a fete for consumers told H___ that "Your being booted was a real blessing in a very thin disguise" I am inclined to speculate negatively about the goodness of such a 'consumer-led-consumer-advocacy.' And there have been other such plaints reported to me... indeed the impression I begin to get might be unfavorably like 'what works' to keep you in such employ is social privileged-positioning, 'publican-politics, power-prior, or even closet-secret-purulence. I shall certainly stand corrected to the degree that I am proven wrong. But certainly much mischief has been accomplished under the 'non-partisan partisanism' of W's New Freedom-- with its back-to-work-bum, outa-CMHC-now message. IF these hard-to-keepers are the only and stressful jobs novel to MH consumers besides the-usual diswashing janitoring Goodwill-working I'd have to say, NO IMPROVEMENT is about the grade I'd give the Cracker Conservatives who dreamed this 'thing' up for us.
--Vernon Lynn Stephens
D.S.M. IV-TR # 296.44
M.S.S.W.
As An-Aging/Stressing-Process???
??? MH-Consumer-Leadership
As Being-Led-Around???
I had good occasion to luncheon with a mover-shaker-of-last-year in the Commonwealth's fledgling consumer movement (in MH that is); this shy one had been in helping services professionally just prior to her understandable fling into peer-services, fathomable for getting a paycheck on the mercenary predictably human end, fathomable for her-kind ('wounded healer,' formerly impaired-professional-- yet even as most consumers desiring to please-people/'help.')
From 2007 to 2008, this pretty lady had emphatically grayed in hair; she was noticeably wrinkled more-the-more (and things like this a gentleman of Southern last will hint not a peep to Belle!) She dropped a strongish suggestion that 'I do not plan to live a year longer now' and I suppose the witting reader might imagine things about this abbreviation-plan as I did.
And I happened to see what kind of reception she got-- who mattered to me most for being the kindest in the coterie there-- with frownies and veiled utterance that somehow her interactions were 'disorganized' (when in fact she did appear organized OK indeed-- and that would mean solid content maybe not with W Churchill rhetoric but fine.)
Seeing this, my mind went back to KYMAP time... some perhaps 5 years ago, when after a hard stint this N.P. led 'consumer-group' went through a drone about how-ya-oughta-take-yer-meds-take-yer-meds-take-yer-meds ilk identical to medication-groups familiar to all consumers hospitalized between 1975-2005-- THEN to something called PACE (Patient Assistance in a Community Existence) which per-its-Web-press read great to me, but WHEN I read the standard-operating-policy&procedures-book Recovery Guide to read such counter-evidenced-overweeningly gems as "Self-managed care is the set of skills for managing severe emotional states without the use of medication" (page 8--may be true only to the degree that the inaugural pathology is not destined-severe I'd say) "Unfortunately, the medical model absolves people of all responsibility for their problems and solutions" (page 9--nearly 98% counter-factual in my experience-- with its many 'reality therapies') there comes a success-story of a MH consumer who so "dealt with the distress at home, without medication" (page 31-- a thin-ice condition no-no to virtually any consumer or MH pro-- ask!) and a jewel of mis-information about the dopamine hypothesis (presumably of schizophrenia) on last-print-page "Mental illness is the loss of dreams, not the loss of dopamine" (as the dopamine-hypothesis of schizophrenia posits a surfeit of inter-synaptic dopamine, whereas Parkinson's Disease-- strictly neuro-- comes from dopamine-dearth.)
It jerked me reading this startling stuff-- I repeat completely turnabout from the modeling from TXMAP of Texas' hyper-compliance-to-professionals-oriented-reading required of us 'leaders' (??? Really who led but the pro med-group leader just like the hospital-ways-- the N.P. of course!!!) SO I said to FearlessFactual NP Leader: " _______ , I regret that I cannot as anticipated support my teaching of PACE-- as it is full of dangerous-for-consumers counter-factual information-- AND IN NUMEROUS WAYS CONTRADICTS THE INTENT OF KYMAP SO VIGOROUSLY AS TO FARSIFY." Response: OK, like good-bye.
So like good-bye to the conscientious-objector. Now the Sweeties still calling this KYMAP sent me a Christmas card, and from it I surmised that about the same old crowd was there in the group-- the paid-members who were to tell-their-story-again-again just like other members unpaid indeed just like group-participants in all group psychotherapies everywhere I know-- but for $12 an hour (I think that's the wage) one hour per week.
This prior experience goodbye of mine and the good-bying I was beginning to witness toward this prematurely aging once pretty-girl she was then leads me to wonder-strongly about the kind of social-envirions the general lot of peer-specialist/MH-consumer-leadership-so-called really might be in the general aggregate. My IMPRESSION-- corroborating with mounting experience-- would be that in a way completely as arbitrary:capricious:thin-ice as dishwashing janitoring (to some lesser extent) Goodwill-working THIS TYPE OF CONSUMER-PEER LEADERSHIP POSITION FOR SOME (say the impecunious) WOULD LACK THE SECURITIES THAT ARE VITAL TO ALL, YES TOO VIGOROUSLY FOR THE MENTAL-PROS I BOTH KNOW AND HAVE-BEEN.
It is becoming well-recognized that the American System of employment-- 'Master & Servant law' unchanged from medievals save for abolition of slavery/involuntary-servitude (13 Amend. U.S. Const.)-- is POISON for the welfare health longevity of its under-participants (but better for the privileged Bosses!) From what I can tell, this paradigm is exactly what-works/operates in the ifffffy business of MH consumer-leadership. For further example, I can point to the case of a woman H___ who was 'hired' by another advocacy-consumer-spin-off in Kaintuck one December, but had a death-in-family-could-she-grieve-come-in-2-weeks-hence??? Nah, H____ was obviously showing bad work attitudes to our-thing!!!! When later a witting MH consumer at a fete for consumers told H___ that "Your being booted was a real blessing in a very thin disguise" I am inclined to speculate negatively about the goodness of such a 'consumer-led-consumer-advocacy.' And there have been other such plaints reported to me... indeed the impression I begin to get might be unfavorably like 'what works' to keep you in such employ is social privileged-positioning, 'publican-politics, power-prior, or even closet-secret-purulence. I shall certainly stand corrected to the degree that I am proven wrong. But certainly much mischief has been accomplished under the 'non-partisan partisanism' of W's New Freedom-- with its back-to-work-bum, outa-CMHC-now message. IF these hard-to-keepers are the only and stressful jobs novel to MH consumers besides the-usual diswashing janitoring Goodwill-working I'd have to say, NO IMPROVEMENT is about the grade I'd give the Cracker Conservatives who dreamed this 'thing' up for us.
--Vernon Lynn Stephens
D.S.M. IV-TR # 296.44
M.S.S.W.
Monday, December 29, 2008
'Paranoia' and Propriety--
Pop-Psychology Diagnosing as Superb Discreditation--
The 'Conditions of a Successful Degradation Ceremony'
[H. Garfinkel]
For Patient-Mentals Including Bipolars
With a professorial friend some few months ago, while I was recounting my experiments in self-management with 'medical home ec' at this Desert, I happened to mention that my ~22 involuntary mental hospitalizations seem many times beyond what I know to be the case for consumers like me-- having done nearly 1000 psychiatric social histories and having had numerous acquaintances with no such record, or at worst, much much less than that. This professorio amigo said: 'Sounds pretty paranoid to me Vern.'
Paranoid. I begin with that assumption, the harrowing exactitude of me-Mommy's derangement, in every one of my empiric assays. I use, let me say, the method known to logic via William of Ockham, logician-theologue, as reductio ad absurdum -- 'process of elimination' essentially rather-- in every one of my important examinations of what is assumed to be reality. I ALWAYS assume that I am possessed of a delusion in any signal inference from reality (so-seeming), and rigorously as possible try to detect the 'holes' in this assumption. [And in fact there have been about 3 occasions in my life when clinically I had a definable paranoid condition-- consitent with exaltation and lasting as momentarily as a few hours, vanishing with some newer phenomenal thrill.] Therefore with this fine assumed paranoia, I begin to work...
It so happened that just prior to the lead-paint eviction from the 315 W. Hill Street apartment-- whereupon I lost my ~40000 books LPs genealogy my-publications-peer-reviewed and first-loved-cat-- I with telephone access in about 1997 had called arrest-statistics with the County over at old Baptist Hospital site now-- and with their figures had learned with computation that in that decade the involuntary-mental-incarceration rate would be about 1/10,000 per lifetime. Of course, 22 involuntaries using the assuming of the Poisson model (for rare events, where the mean = variance) would suggest a vast statisticality associated with my 'dangerousness'-- hard to figure out for a person who NEVER did any hitting just shouting to net this and who NOW is so radically-dangerous as to have vowed never-never-never to hit-when-assaulted (which at any rate is still an excellent way for the police to assess a row, and arrest-ya-victim.) When I told my Professorio buddy this then-- I just just months ago-- he responded that this still must just be a fluke (with the suggestion of paranoid inference I trow) as SO SO SO MANY mental-incarcerations now must occur with Seven Counties Services (SCS) turning away so many mental consumers to do 'the first thing that comes to mind.'
And there MAY be some truth to this assertion. Indeed, the last presentation I heard Dr. Howard Bracco CEO of SCS make, to General Assembly, was that jailings of this type could now be expected as the result of program guttings-cuttings-consolidations. But-- in a computation facile because the mean=variance with the Poisson, I rejoined then to the effect that if every single mental patient with schiz or bipolar hue [about 2% of the population demographic in most American places--certainly not much greater than 20000 folks-- and I know of numerous patient-patient-mentals who ain't ever had a mental bust] had such a lock-up per individual lifetime, this would be for me ~ 22/(square-root-of-2E-4) ... several standard deviations from the mean into significance, conservatively...
[And now I have done a more precise computation: the P/confidence-interval associated with the usual computation of a Poisson probability [refer to the texts extant]-- which from my normal table is approximately 1.22...E-92, which does mean that by-chance we would expect such an occurrance once in 81-with-~90-zeros totally random trials. EITHER I am more dangerous therefore than the most-dangerous criminal in Death Row at Eddyville Penitentiary in Western Kentucky or there has been some other-- dare one suggest arbitrary-capricious-- use of governance as yet unexplained to me creating this (which I can hardly do-other than take-personally) statistical outlier. {Post-script: I regret my several prior revisions of these figures-- the first of which was errant in assuming a 'mean' of mental incarcerations per individual this Metro of .2-- whereas it is actually at .0002. I did a 'stab' with the computation of standard-deviations at P-- but using the assumption of the 'normal/bell curve.' The figures here just above are for 'e to the power of the mean-negative X the mean to the pertaining power per extant cases divided by the factorial of the number of extant cases.'}]
To this general report, my Prof friend responded, I-do-think-this-true there's-nothing-I-can-do-about-it sorry-you-have-to-hermit-yourself-now-in-your-apartment still-sounds-paranoid-to-me. This is just about the answer I get from all kind-and-usuals in my social life. Somehow the very reportage of a real verity is describable as paranoid-- an interesting linguistic turn (I can almost recall its emergence in Hippie Era from those who had learned a slight vocab from university abnormal psych classes) that paranoia=anger=suspecting-bad-things-suggestively.
Paranoia is by legitimate clinical definition a delusional disorder-- meaning that categorically there would have to be an: (1) absolute-conviction/willful-certainty imputed, (2) which cannot be dissuaded by experience (including reason and good-inference), (3) which is impossible (meaning false.) Apart from this, I recall the Hippies making much-hay of 'paranoid people' having any suspicion (to some degree veritable) that folk are doing-dope, talking-overthrow-of-government, and thus-of-investigational-interest-to-police etc. This is well-reflected in the banter now on the Web about paranoia-- for on the 7th of this month, I did a Dogpile.com search to detect the emotional-valence and semantics of the use 'paranoia'-- and found that even in professedly clinical sites there is use of this term as 'anger,' 'PTSD,' suspicion,' 'irritation,' 'egotism/Narcicissm,' and rather-off-delusional-predication-first-assumption, and the emotional valence whether clinical/non-clinical of the term paranoia was [of options, '+' '-' 'Neutral' 'Uncertain'] negative 46 of 50 citations; the multinomial probability of this occurance with the other statistics was P <1.8...E-25 [by chance expectable once in 55 000 000 000 000 000 000 000 000 totally random trials], odds-ratio [OR] =132.25, CI 95% 31.31 - 558.470; thus with some empiric-conservatism-- the real kind of Conservative [not-'Political-,' not-'Social-'] I am-- perhaps now I can say that this common use of 'paranoia'-- NOT clinical I reiterate by clearest terminology-- is highly pejorative, even 'damning' in almost every use-- and a GREAT way to discredit anyone.
This truism is certainly not unknown in psychiatry. One needs to look e.g. for the diagnosis of 'paranoid' ilk labeling when a clinician begins to have trouble with a client/patient-- let us strongly suggest that such an occasion would be contiguous thence to say service-complaints-- and a great way to justify to The Brass and utilization-review [UR] that this complainer-should-not-be-believed. At any rate, even when I stridently was urging MH clinicians-mine to put the sickest diagnosis they had for my 1977 whamo etc. there NEVER has been a 'paranoid' term in my diagnosis, nor indeed has there been diagnosis not-definably-affective (emotional) in nature.
TO ME what does this mean? I think it means that my existential assumptions are approximately about accurate: that while there is truth to all this statistical banter I present-- at elegance the very very very language of all the sciences at core of psychiatry-- any/every report to others-- yea to the loving Treaters of treats in MH-- will likeliest be dismissed under the pop psychology Hippie rubric of 'paranoid, Man, paranoid.' Best to keep it to myself, y'know; and more-to-the-point, better to tuck myself away from the KRS 202A.041 pop cop psychiatrists-- if I 'know what's good for me.'
--Vernon Lynn Stephens
D.S.M. IV-TR # 296.44
M.S.S.W.
Pop-Psychology Diagnosing as Superb Discreditation--
The 'Conditions of a Successful Degradation Ceremony'
[H. Garfinkel]
For Patient-Mentals Including Bipolars
With a professorial friend some few months ago, while I was recounting my experiments in self-management with 'medical home ec' at this Desert, I happened to mention that my ~22 involuntary mental hospitalizations seem many times beyond what I know to be the case for consumers like me-- having done nearly 1000 psychiatric social histories and having had numerous acquaintances with no such record, or at worst, much much less than that. This professorio amigo said: 'Sounds pretty paranoid to me Vern.'
Paranoid. I begin with that assumption, the harrowing exactitude of me-Mommy's derangement, in every one of my empiric assays. I use, let me say, the method known to logic via William of Ockham, logician-theologue, as reductio ad absurdum -- 'process of elimination' essentially rather-- in every one of my important examinations of what is assumed to be reality. I ALWAYS assume that I am possessed of a delusion in any signal inference from reality (so-seeming), and rigorously as possible try to detect the 'holes' in this assumption. [And in fact there have been about 3 occasions in my life when clinically I had a definable paranoid condition-- consitent with exaltation and lasting as momentarily as a few hours, vanishing with some newer phenomenal thrill.] Therefore with this fine assumed paranoia, I begin to work...
It so happened that just prior to the lead-paint eviction from the 315 W. Hill Street apartment-- whereupon I lost my ~40000 books LPs genealogy my-publications-peer-reviewed and first-loved-cat-- I with telephone access in about 1997 had called arrest-statistics with the County over at old Baptist Hospital site now-- and with their figures had learned with computation that in that decade the involuntary-mental-incarceration rate would be about 1/10,000 per lifetime. Of course, 22 involuntaries using the assuming of the Poisson model (for rare events, where the mean = variance) would suggest a vast statisticality associated with my 'dangerousness'-- hard to figure out for a person who NEVER did any hitting just shouting to net this and who NOW is so radically-dangerous as to have vowed never-never-never to hit-when-assaulted (which at any rate is still an excellent way for the police to assess a row, and arrest-ya-victim.) When I told my Professorio buddy this then-- I just just months ago-- he responded that this still must just be a fluke (with the suggestion of paranoid inference I trow) as SO SO SO MANY mental-incarcerations now must occur with Seven Counties Services (SCS) turning away so many mental consumers to do 'the first thing that comes to mind.'
And there MAY be some truth to this assertion. Indeed, the last presentation I heard Dr. Howard Bracco CEO of SCS make, to General Assembly, was that jailings of this type could now be expected as the result of program guttings-cuttings-consolidations. But-- in a computation facile because the mean=variance with the Poisson, I rejoined then to the effect that if every single mental patient with schiz or bipolar hue [about 2% of the population demographic in most American places--certainly not much greater than 20000 folks-- and I know of numerous patient-patient-mentals who ain't ever had a mental bust] had such a lock-up per individual lifetime, this would be for me ~ 22/(square-root-of-2E-4) ... several standard deviations from the mean into significance, conservatively...
[And now I have done a more precise computation: the P/confidence-interval associated with the usual computation of a Poisson probability [refer to the texts extant]-- which from my normal table is approximately 1.22...E-92, which does mean that by-chance we would expect such an occurrance once in 81-with-~90-zeros totally random trials. EITHER I am more dangerous therefore than the most-dangerous criminal in Death Row at Eddyville Penitentiary in Western Kentucky or there has been some other-- dare one suggest arbitrary-capricious-- use of governance as yet unexplained to me creating this (which I can hardly do-other than take-personally) statistical outlier. {Post-script: I regret my several prior revisions of these figures-- the first of which was errant in assuming a 'mean' of mental incarcerations per individual this Metro of .2-- whereas it is actually at .0002. I did a 'stab' with the computation of standard-deviations at P-- but using the assumption of the 'normal/bell curve.' The figures here just above are for 'e to the power of the mean-negative X the mean to the pertaining power per extant cases divided by the factorial of the number of extant cases.'}]
To this general report, my Prof friend responded, I-do-think-this-true there's-nothing-I-can-do-about-it sorry-you-have-to-hermit-yourself-now-in-your-apartment still-sounds-paranoid-to-me. This is just about the answer I get from all kind-and-usuals in my social life. Somehow the very reportage of a real verity is describable as paranoid-- an interesting linguistic turn (I can almost recall its emergence in Hippie Era from those who had learned a slight vocab from university abnormal psych classes) that paranoia=anger=suspecting-bad-things-suggestively.
Paranoia is by legitimate clinical definition a delusional disorder-- meaning that categorically there would have to be an: (1) absolute-conviction/willful-certainty imputed, (2) which cannot be dissuaded by experience (including reason and good-inference), (3) which is impossible (meaning false.) Apart from this, I recall the Hippies making much-hay of 'paranoid people' having any suspicion (to some degree veritable) that folk are doing-dope, talking-overthrow-of-government, and thus-of-investigational-interest-to-police etc. This is well-reflected in the banter now on the Web about paranoia-- for on the 7th of this month, I did a Dogpile.com search to detect the emotional-valence and semantics of the use 'paranoia'-- and found that even in professedly clinical sites there is use of this term as 'anger,' 'PTSD,' suspicion,' 'irritation,' 'egotism/Narcicissm,' and rather-off-delusional-predication-first-assumption, and the emotional valence whether clinical/non-clinical of the term paranoia was [of options, '+' '-' 'Neutral' 'Uncertain'] negative 46 of 50 citations; the multinomial probability of this occurance with the other statistics was P <1.8...E-25 [by chance expectable once in 55 000 000 000 000 000 000 000 000 totally random trials], odds-ratio [OR] =132.25, CI 95% 31.31 - 558.470; thus with some empiric-conservatism-- the real kind of Conservative [not-'Political-,' not-'Social-'] I am-- perhaps now I can say that this common use of 'paranoia'-- NOT clinical I reiterate by clearest terminology-- is highly pejorative, even 'damning' in almost every use-- and a GREAT way to discredit anyone.
This truism is certainly not unknown in psychiatry. One needs to look e.g. for the diagnosis of 'paranoid' ilk labeling when a clinician begins to have trouble with a client/patient-- let us strongly suggest that such an occasion would be contiguous thence to say service-complaints-- and a great way to justify to The Brass and utilization-review [UR] that this complainer-should-not-be-believed. At any rate, even when I stridently was urging MH clinicians-mine to put the sickest diagnosis they had for my 1977 whamo etc. there NEVER has been a 'paranoid' term in my diagnosis, nor indeed has there been diagnosis not-definably-affective (emotional) in nature.
TO ME what does this mean? I think it means that my existential assumptions are approximately about accurate: that while there is truth to all this statistical banter I present-- at elegance the very very very language of all the sciences at core of psychiatry-- any/every report to others-- yea to the loving Treaters of treats in MH-- will likeliest be dismissed under the pop psychology Hippie rubric of 'paranoid, Man, paranoid.' Best to keep it to myself, y'know; and more-to-the-point, better to tuck myself away from the KRS 202A.041 pop cop psychiatrists-- if I 'know what's good for me.'
--Vernon Lynn Stephens
D.S.M. IV-TR # 296.44
M.S.S.W.
Saturday, December 27, 2008
NOT ABLE
'To Cast the First-Stone'--
With Loathing I Recall My Once Historic
Kicky Violence Violation
I attend whatever 'patiently' educational experiences I can obtain: now, sans any notice of what-gives in psych Grand Rounds, I get most of this by inspiration from the Web, and from my derivative experiences trying hard to observe myself (one who seemingly is manic-depressive/bipolar despite whatever making-worse I try to grade myself in 'schizifying' 'paranoia-ing'.) Sometimes the Internet then gives me occasion to this hard self-observation, and IF there is any way of verifying even the most-horrific about myself, I think I do so (being my-own 'toughest grader.')
Thence, I was able thanks to the New England Journal of Medicine (NEJM) to 'audit' an interview last night with Dr. Richard A. Friedman, M.D. who had written an article for the pertinent November 16, 2006 NEJM about the violence potential of mental patients-- the ones who are not so 'patient' but strike-out. Upon hearing that interview by the media player at wee hours this a.m., I read and regarded the apparent article pertinent to this talk.
My honest response to this news-- subsequent to the real event of a patient institutionalized fisting to death a psychiatrist-- was of considerable self-loathing-- for my 'kind' first of all for I knew that there is potential for im-patient patients in psych to be violent-- a reality approached with generalized dismissiveness by mental health advocacy groups-- but real. With this realism I regarded with existential nausea a graphic associated with this article to the effect that the LIFETIME violence history of non-patients psychiatric was at 7.3%, whereas 16.1% for those who have either a schizophreniform or affective disorder (the older designation for this 'functional psychosis' becoming increasingly more tenuous with the arriving journalism reportage from neuroscience fMRIs etc.) Quickly computing the ODDS RATIO pertinent to be 2.43 (without any way to establish confidence intervals [CIs] from percentages as given) -- not counting the inexorable violence potentiation associated with pure or psychotic-use substance abuse-- I ESTEEMED THIS TO BE THE DAY'S TORAH-SCHOOL-LESSON [EVER WITH THE CERTITUDE THAT THE LAW-OF-NATURE = THE-LAW-OF-JAHWEH/ALLAH.]
I indeed have written about this violence potential. In keeping with my tendency to regard the worst in myself correctively prior to assessing anyone else, I tried to sift through in my mind that somehow I am disconnected from this '16.1%'-- and this with the recognition that as practiced for some time this year I took -and published-- a vowing that I would NEVER do-violence EVEN if beaten by anyone. I was indeed almost ready to 'let myself off the hook' and as this would be old-ground bed myself in dismissal on the topic. THEN memory emerged. Back and back and back I went through the series of ~ 22 hospitalizations beaten and unbeaten to about 1989 when indeed I did-fracas, was im-patient patient 'kicky' [somewhat approximately.] By reference to my CCed notes, I would assess this to have been the involuntary hospitalization from 2/23-3/14/1989. THEN I mysteriously to staff turned about in a crowded ward and kicked-out, then withdrew-the-kick; and this certainly was charted as I 'caught it' in a later staffing s.p. a seclusion. Why did I DO this violence? A paragraph-long story emerges from the question...
Upon admission the orderly/male-attendant in this public place punched my gut breathtakingly as he settled me in my room. I knew better than to gasp-- it would cause problems. Then on the sometimes when he would lead me back from one of the several group-treatments there/then, he-- same guy-- would kinda-karate punch my back-of-neck as I was secure inside the dorming area-- and I suppose out of view-- that is always ever 100% of the time how beatings occur to mentals unless by the cops-- who can justify it with the violence potential exibited hypothetically and with the notorious discreditability of psychotics. Anywho, when on the day I was kicky, I certainly thought that this male attendant was again so coming to me from behind, with this time a yen to publicly kinda-karate my back neck. By this time, come H or HighWater, I had decided to strike-back a tad-- and when the putative 'he' was right behind me in the day room (at the door) I turned kicked-halfway-- but SURPRISE-- nobody like that beater was there-- so a placed-kick became an empty-half-kick. This was explained in the pertinent staffing after my seclusion. What if anything credible resulted from my violent incredibility I know not. Time, like all excretion, went on...
So in my recorded life-history, I am INDEED in the 16.1 designated above. No way out. This graph makes no aspersion about the circumstances of the violence done-- only that one has this in one's history. And unless he got a good sit-down-job at Food Stamps or was arrested for some goofus outside of the facility there, this 'respected Merit System employee' likeliest is still there, getting his licks in, perhaps one could say.
I in turn know what would happen if I EVER hit-back an assailant-- something comparable to the cases I would get in Grauman Unit Forensic Psychiatry of mentals who in being mugged beat back an assailant, who perpetrator calling the police would get a wee charge of something disorderly disturbing dangerous violent on the less-patient-patient -- and PRESTO! a mental lock up. There IS something politic, and quite functional i.e. about my published avowal not-to-hit-back. This is with my Jesus Discipleship attempt strongly motivates. The PROBLEM of course would be that this makes me extremely VULNERABLE especially here in the crime-stained Desert in which I comfortably-otherwise live. There used to be some pain associated with this aversion to public exposure albeit I certainly could use a few reliable friends (a hole in my Mitwelt now.) I doubt not at all though that some jaundiced-one could 911 me for any mischief, just perchance to see the cops here by example, and discreditable me would go away to some mental-justice-court-ed condition at the ilk of a Universality H or some other nice or un-nice jailing. IF there would ever be a question of my violence violation between myself and Officer, 'the testimony of the sworn-one' would be the sticker.
This is a totally existential situation. ONCE I was [almost] violent-- and forever there will be the assumption of the unredeemed person here in this pad [I do NOT mean the cat!] What is more, there is no bitterness, and certainly nothing more apparent to me than a dead-reckoning with my presumed-me, my-sometimes-me, and the cheap discount of all experientiality about me. Lessons thus learned in the way toward getting-better [never 'good'-- Jesus witting better] I go on, with profoundest apologies regrets sorries for my violating violence potential and all violence in 'my kind.'
--Vernon Lynn Stephens
D.S.M. IV-TR # 296.44
M.S.S.W.
'To Cast the First-Stone'--
With Loathing I Recall My Once Historic
Kicky Violence Violation
I attend whatever 'patiently' educational experiences I can obtain: now, sans any notice of what-gives in psych Grand Rounds, I get most of this by inspiration from the Web, and from my derivative experiences trying hard to observe myself (one who seemingly is manic-depressive/bipolar despite whatever making-worse I try to grade myself in 'schizifying' 'paranoia-ing'.) Sometimes the Internet then gives me occasion to this hard self-observation, and IF there is any way of verifying even the most-horrific about myself, I think I do so (being my-own 'toughest grader.')
Thence, I was able thanks to the New England Journal of Medicine (NEJM) to 'audit' an interview last night with Dr. Richard A. Friedman, M.D. who had written an article for the pertinent November 16, 2006 NEJM about the violence potential of mental patients-- the ones who are not so 'patient' but strike-out. Upon hearing that interview by the media player at wee hours this a.m., I read and regarded the apparent article pertinent to this talk.
My honest response to this news-- subsequent to the real event of a patient institutionalized fisting to death a psychiatrist-- was of considerable self-loathing-- for my 'kind' first of all for I knew that there is potential for im-patient patients in psych to be violent-- a reality approached with generalized dismissiveness by mental health advocacy groups-- but real. With this realism I regarded with existential nausea a graphic associated with this article to the effect that the LIFETIME violence history of non-patients psychiatric was at 7.3%, whereas 16.1% for those who have either a schizophreniform or affective disorder (the older designation for this 'functional psychosis' becoming increasingly more tenuous with the arriving journalism reportage from neuroscience fMRIs etc.) Quickly computing the ODDS RATIO pertinent to be 2.43 (without any way to establish confidence intervals [CIs] from percentages as given) -- not counting the inexorable violence potentiation associated with pure or psychotic-use substance abuse-- I ESTEEMED THIS TO BE THE DAY'S TORAH-SCHOOL-LESSON [EVER WITH THE CERTITUDE THAT THE LAW-OF-NATURE = THE-LAW-OF-JAHWEH/ALLAH.]
I indeed have written about this violence potential. In keeping with my tendency to regard the worst in myself correctively prior to assessing anyone else, I tried to sift through in my mind that somehow I am disconnected from this '16.1%'-- and this with the recognition that as practiced for some time this year I took -and published-- a vowing that I would NEVER do-violence EVEN if beaten by anyone. I was indeed almost ready to 'let myself off the hook' and as this would be old-ground bed myself in dismissal on the topic. THEN memory emerged. Back and back and back I went through the series of ~ 22 hospitalizations beaten and unbeaten to about 1989 when indeed I did-fracas, was im-patient patient 'kicky' [somewhat approximately.] By reference to my CCed notes, I would assess this to have been the involuntary hospitalization from 2/23-3/14/1989. THEN I mysteriously to staff turned about in a crowded ward and kicked-out, then withdrew-the-kick; and this certainly was charted as I 'caught it' in a later staffing s.p. a seclusion. Why did I DO this violence? A paragraph-long story emerges from the question...
Upon admission the orderly/male-attendant in this public place punched my gut breathtakingly as he settled me in my room. I knew better than to gasp-- it would cause problems. Then on the sometimes when he would lead me back from one of the several group-treatments there/then, he-- same guy-- would kinda-karate punch my back-of-neck as I was secure inside the dorming area-- and I suppose out of view-- that is always ever 100% of the time how beatings occur to mentals unless by the cops-- who can justify it with the violence potential exibited hypothetically and with the notorious discreditability of psychotics. Anywho, when on the day I was kicky, I certainly thought that this male attendant was again so coming to me from behind, with this time a yen to publicly kinda-karate my back neck. By this time, come H or HighWater, I had decided to strike-back a tad-- and when the putative 'he' was right behind me in the day room (at the door) I turned kicked-halfway-- but SURPRISE-- nobody like that beater was there-- so a placed-kick became an empty-half-kick. This was explained in the pertinent staffing after my seclusion. What if anything credible resulted from my violent incredibility I know not. Time, like all excretion, went on...
So in my recorded life-history, I am INDEED in the 16.1 designated above. No way out. This graph makes no aspersion about the circumstances of the violence done-- only that one has this in one's history. And unless he got a good sit-down-job at Food Stamps or was arrested for some goofus outside of the facility there, this 'respected Merit System employee' likeliest is still there, getting his licks in, perhaps one could say.
I in turn know what would happen if I EVER hit-back an assailant-- something comparable to the cases I would get in Grauman Unit Forensic Psychiatry of mentals who in being mugged beat back an assailant, who perpetrator calling the police would get a wee charge of something disorderly disturbing dangerous violent on the less-patient-patient -- and PRESTO! a mental lock up. There IS something politic, and quite functional i.e. about my published avowal not-to-hit-back. This is with my Jesus Discipleship attempt strongly motivates. The PROBLEM of course would be that this makes me extremely VULNERABLE especially here in the crime-stained Desert in which I comfortably-otherwise live. There used to be some pain associated with this aversion to public exposure albeit I certainly could use a few reliable friends (a hole in my Mitwelt now.) I doubt not at all though that some jaundiced-one could 911 me for any mischief, just perchance to see the cops here by example, and discreditable me would go away to some mental-justice-court-ed condition at the ilk of a Universality H or some other nice or un-nice jailing. IF there would ever be a question of my violence violation between myself and Officer, 'the testimony of the sworn-one' would be the sticker.
This is a totally existential situation. ONCE I was [almost] violent-- and forever there will be the assumption of the unredeemed person here in this pad [I do NOT mean the cat!] What is more, there is no bitterness, and certainly nothing more apparent to me than a dead-reckoning with my presumed-me, my-sometimes-me, and the cheap discount of all experientiality about me. Lessons thus learned in the way toward getting-better [never 'good'-- Jesus witting better] I go on, with profoundest apologies regrets sorries for my violating violence potential and all violence in 'my kind.'
--Vernon Lynn Stephens
D.S.M. IV-TR # 296.44
M.S.S.W.
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