August 2, 2015 by

I do not understand affliction. I had a friend once who told me that life “was nothing but beans and hard times.” Him and his wife had given birth to two deaf-blind children because of a recessive gene they both had…. the odds were incredible against that happening. I forget the numerical odds exactly but something similar to the odds of getting hit by lightning. He didn’t understand affliction either.

Things happen. To you…. To me… To everyone. Adverse life events they call them. Science even is beginning to believe that “what happened?” actually has something to do with the way we lead our lives and the people we become.

Pain counts. There are many things hard to find in this life. Tragedy is not one.

I have talked often in this blog about the tragedies I have known. I have met many who have known far worse things than me and am in continual awe of the human capacity to meet terror and pain with courage and quiet faith.

For me, at its worst, the most difficult thing is the tenaciousness of tragedy. It never wants to leave. Its footprint too easily is seen in each new day. Coping sometimes seems a miracle, but it seems sometimes a miracle that has to be redone each day.

Feeling bad makes me feel like a failure and I often feel bad. Trauma often feels new and alive even when it is neither. It is not that it was once where I was as much as it seems like where I still am or where I am about to go.

Things do get better with time sometimes. Life sometimes captures our hurts and puts it on the back burner of a busy stove. Things that once felt like everything are dissipated by perspective. And things are more than what they make of us. We can also make of them.

Someone today told me a wise thing. “Sometimes we are hurt and hurt badly. Sometimes we are changed and sometimes in ways we hate with a passion. Trauma though even when it changes us doesn’t condemn us. We can find restoration, sometimes in small and slow steps. It doesn’t mean things are not hard or that we don’t take steps backward. It means we can take steps and what we do matters. ”

” Adverse life events” tell us many things about ourselves, other people and life in general. But no matter how compelling, how loud or how emphatic they are not the final verdict. That is always on us.

Recovery as what the mental health system is supposed to be about

August 1, 2015 by


From the archives

Originally posted on Hopeworks Community:

One of the simply silliest ideas I have heard recently is the one that says that recovery is remission and it doesnt matter what you do if you are going to go into remission you are going to go into remission and what you do is not important.  It is not something you can take credit for.  It simply happens.  It is kind of a psychiatric predestination.

The only people I know who believe this are those that in some are associated with the Treatment Advocacy Center.  I have worked in the mental health system for 38 years and have never met one professional who believed anything remotely like this.

Dr. William Anthony started writing about recovery over 20 years ago and was one of the founders of the field of psychiatric rehabilitation.  The post below is from the archives of this blog and largely based on his writing.


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The “what you are” myth: when labels become cancerous

July 31, 2015 by


From the archives

Originally posted on Hopeworks Community:

Why do some people buy into the reality of recovery and some people seemingly never do?  Some people see opportunity in the midst of the most severe suffering.  Some people only see the suffering.  Some people believe life is about learning and using what you learn to improve your  life and become more of the kind of person you want to be.  They believe that effort is important, that persistence counts, and that they can bounce back from the most difficult of circumstances.  They see hope and instruction in the lives of others.  They are open to often difficult feedback because they know that protecting where they are at keeps them from going where they want to go.

Other people see life as being about judgment and that the real world experience of a mental health diagnosis is the cruelest and meanest of judgments.  They view the distinction between “having…

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Ordinary circumstances

July 31, 2015 by

I have come to believe over recent years that most people with mental health issues are ordinary people coping with extraordinary circumstances.   They are not as stigma and prejudice would have you believe deficient people messing up ordinary circumstances.

Much of what it means to have mental health issues is to have a history of hurt, of abuse,  of victimization.   Much of what it means to survive and even prosper with such a history is to be courageous.   The courage of people having to deal with significant distress as part of daily living is normally not seen and appreciated.   It is one of the most significant blind spots in much treatment.   The message of the incredible strength of troubled people and the potential of that strength as an essential resource in further change is just so seldom heard.

People survive disaster.   People learn from disaster.   People transcend the disasters in their lives.  

People hurt have a lot to learn to get past the injury in their lives. But they also have much to teach and it is long past time for all of us to recognize the courage of ordinary people and to know in their struggles we can find hope for our own.

Representative Murphy did you know Congress has an 8% approval rating

July 30, 2015 by

Congressman Murphy I heard last night that Congress had an 8% approval rating and I thought of you.   I remember a long time ago you used a word describing PAIMI that you don’t hear much anymore – reprehensible.   And it hit me last night that is the word that most people apply to Congress.   They lament that Congress is so dysfunctional it can’t pass needed legislation but perhaps we need to be grateful it is so dysfunctional it can’t pass bad legislation either.

Some things stand out about the new bill….

I have been told by lots of people in a position to know that you were told that as long as your bill was so partisan it would never see the outside of the committee room. I wonder if that is why Dr.  Torrey and Mr. Jaffe no longer seem to be on the front line of this bill with you.  They are the essence of partisanship and a scorched earth advocacy approach.  It seems Patrick Kennedy is your new poster child and the combination of him and Dr.  Lieberman and the new head of MHA is much more of a formidable  crew.   Dr.  Torrey I  think is a little like the Donald Trump of psychiatry: always good for a sound bite,  beloved by many and despised by many more.   I think the combination of AOT as your flagship and Torrey as the pilot of the boat was too much for anyone to overcome.

A primarily AOT bill is not going to pass.   Dr Torrey never had the influence or audience he thought he had.  You seem to finally realize that and I suppose the AOT incentive is your compromise.   You probably know more than me but I have been told that an AOT incentive is not making it through the Senate.

I  simply do not understand how, even if they have made mistakes,  you can be against the unfettered operation of an organization that protects the rights of those you claim to be for.  The mental health system,  and certainly the mental health system as you would like it to be,  has earned no blank check of trust and in a free society never should.

You seem to have a very personal gripe against Samhsa.   The best I can tell your solution to the bureaucracy of Samhsa is a bureaucracy not named Samhsa.   People I know tell me your personal animus towards Pamela Hyde is well known and it seems she feels the same about you.  The perception of Samhsa in Tennessee is largely positive and I know of no one who understands let alone agrees with your claim that it is a terminal virus on the mental health system.   This  battle seems highly partisan and I have a hard time believing a democratic president is going to sign something destroying it. I  also think this is going to be a hard sell in the Senate.

How are you going to get the increased federal bankrolling of psychiatric hospitals to be budget neutral?  I don’t think the Republicans will even vote for that.

I think you have a very hard road to hoe.   It is August and you are still not out of the committee and the Senate has not even started.   The presidential campaign is going to put a halt to a lot.   I  understand that some members of Congress are still hunting the speakers head. I  wonder how much could happen even if everyone wanted it to. Your organization just sounds like a chaotic mess and the clock is ticking.   And August is vacation time for you guys I think.

8% approval rating.  Unless you are a Republican candidate for president that is scary low.

There are no small successes

July 30, 2015 by

Survival is:

Doing as many good things as possible. Somethings make it more likely to be a good day. Do good day things.

Anticipate problems as far ahead as I can. “Getting worse” is a lot easier (and more effective) to deal with than “worse”. If you are standing out in the middle of the road cars get more dangerous the closer they get to you. From a mile off the success in getting out of the road is much higher than from a foot.

Have a plan to cope. Avoid all the unnecessary things you can. Cope with everything else. Use your plan. Change it to make it better.

Sometimes nothing works. No matter how well thought out or how hard you try things may not work. Get used to it. The things in the way are not in the way. They are the way.

Frustration feeds a desire and screaming need to be in control. You’re not. The pursuit of control feeds more problems than it starves.

Help. Give freely and receive freely. Know people that matter and let them matter. Easy to say…. hard to do.

Have a plan to survive what you cant cope with. Know how you can get past disasters. You already have many times. Make use of what you know.

Celebrate small successes. Eventually you realize there are no small successes.

There are no smooth paths. Life is not eraseable.

When a bad thing is over let it be over. Too often we don’t.

I don’t know our answers. Slowly I am beginning to realize some things don’t change. You do the best you can and try your best to be okay with it. Then you try again tomorrow.

On change…..

July 30, 2015 by

This blog has been going for years now and is approaching 4000 posts. I  spent some time in the last couple of weeks looking back at past years and although much has stayed the same much has also changed.   I’ve changed and to be honest I am not sure I like some of the changes.

I  am not as optimistic as I once was. I once thought if people could be taught the recovery skills they needed and practice those things until they became second nature life would most assuredly get better. I still see truth in that but know now that it is much more complicated than that.

It is not a matter of doing the right 5 things or the right 10 things.   There is no recipe.   There is no if you just try harder or if you practice more or learn something different it will all be okay.   There is no checklist to life.   Doing good things matter but life cannot be cured.   Sometimes it is just hard.    Sometimes it just sucks.   Part of life is joy but part of life is tragedy.

Some things can be changed.   Some things cannot.   Some things can only be survived.   I know many people who try hard,  who have a lot courage and a lot of character who know suffering better than anything. If you have lived and never known tragedy you are way past lucky.

I have learned that challenges are not what gets in the way.   They are the way.   I have learned that how we cope with things is  no more important than how we survive what we can’t cope with.

I  don’t feel nearly as safe as I once did and I have met more and more people who seem to feel the same way.  In the last couple of years personal tragedy has overtaken my life and I  know that is a large part for me.   There are things that for us that could be done by the government that could really make a difference and maybe the hardest thing has been to realize those things may never happen.

I  have become very unhappy and wonder every day if life really can get better when so much sadness and disappointment seems so much a given.

But it is even more than that.  Hatred and anger seem to be so much of what our culture is about.   Our political institutions seem stuck and defined more by division and partisanship than anything.   It is scary and very disheartening.   For some people our government seems more dangerous than any of the foreign enemies we worry about. And I wonder how long problems can go unsolved or even ignored before the  bills become due.   And I wonder if we are already started to pay.

I wish I could still hold on to simple optimism. I  wish hope was easier.   And I really wish unhappiness was not so familiar.  I know writing this blog used to be a lot easier.  I used to write every day and now that seems something I can’t believe I ever did.

I hope good things are ahead and am very grateful to those who continue to read. There are probably many changes yet ahead.   The company has been well appreciated.

Thanks and God bless.


July 28, 2015 by


From the archives

Originally posted on Hopeworks Community:

Adapted from an earlier post

Bad things happen faster than they should and last longer than seems right.

Good things happen slower than they should and never last as long as we feel like they should.

We never have a problem coming up with good reasons to do things that are often not good ideas.

We normally think finding out whose fault it is is the best explanation for everything.

We dont appreciate the momentum of life enough.  The better things are going the more likely it is that better things will happen.

Figure out the difference between what you do on good days and what you do on bad days.  Do more good day things.

Tell people thank you for things you wish they would tell you thank you for.

Be aggressively kind.

No matter what you think the sky is seldom falling.

Dont treat unimportant things importantly.


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ON serenity, courage and wisdom

July 28, 2015 by


From the archives

Originally posted on Hopeworks Community:

Serenity is not the product of our actions, but rather a by product of the way we see. To have serenity means to believe in a larger truth. It means believing that the life is about more than what is happening right now. It means believing that life is about more than me. It means believing that it has a direction and purpose and trusting and believing in that purpose. When I read about people who have coped with extreme misery and disaster in their lives with serenity the one thing they all have in common is the certainity of a greater truth and greater purpose.

One of the greatest lies told to people with mental health issues is that they are incapable of living lives of purpose, that the most they can hope for is a marginal life. The idea that they can base their life on a greater…

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The Murphy Bill: Old Wine in New Bottles or Rep. Murphy, We Can Do Better than This

July 27, 2015 by


Well worth reading

Originally posted on Campaign for Real Change in Mental Health Policy:

By Andrea Blanch, PhD, and David Shern, PhD

In June, the Helping Families in Mental Health Crisis Act of 2015 (H.R. 2646) was introduced by Reps. Tim Murphy (R-PA) and Eddie Bernice Johnson (D-TX).  Several groups have applauded the bill for focusing attention on the need for strengthening the nation’s mental health system.  Unfortunately, the bill proposes very little new, contains provisions that could prove harmful to the very people it is intended to help, and ignores significant scientific advances in our understanding of the causes and treatment of mental illnesses.

Others have criticized in detail the bill’s emphasis on institutional and coercive approaches to treatment rather than on effective, voluntary community-based services; the elimination or drastic reduction in important programs overseen by the Substance Abuse and Mental Health Services Administration (SAMHSA); provisions that would curtail or limit enforcement of civil and privacy rights; and structural problems with proposed changes…

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Hatred is not a mental illness

July 27, 2015 by

Explaining murder without talking about hatred is like talking about fish without the notion of water. Rather it is a an individual hatred or hatred tied to a larger cause much of murder is about making a statement, teaching someone a lesson or making sure others suffer as they deserve. And hatred is not a mental illness. If it is then we are all sick.

Hatred begats anger.

Anger fed begats rage.

Rage begats violence.

Violence begats murder.

Murder confirms hatred.

Hatred confirmed starts the cycle again.

We have made hatred easy. Problems are about who to blame and how to get them back. We are divided by what we call each other and that distinction is seen as the most real thing there is. There are people like us and people not like us and the people not like us are why things are so hard and so messed up.

We live constantly provoked. Anger is what we take out of a situation and there is no shortage of offense to pick from. The people we hate seem constantly to confirm we have reason to hate them.

After awhile we no longer get angry. Anger is simply what we are. Rage is not what we get from a situation. It is what we bring to the situation. The rageful person lives at war. It becomes not what we see in life but the means by which we see or make sense of life.

We worship violence. The rhetoric of violence is celebrated in political discourse, social media and popular culture. There are serious arguments made that the problem with church, with movies, in parks, with grocery stores and other public places is that not enough people carry guns. There are people who believe it is silly to go anywhere not prepared to shoot back. For the rageful violence is one of the few things that make sense.

A lot of people get shot. The amount of gun casualties in this culture dwarfs that of most wars. We live in a cowboy culture that judges violence not by its frequency but by rather or not the right people get shot.

We always find good reason for the most horrible things. We may suffer from lack of justice but we have no lack of justification. Hatred justifies almost anything.

The pattern described above does not describe everyone. I hope it is an all the time description of very few people in fact. But it describes enough people enough of the time to leave us with the periodic horrors that seem almost a daily occurrence.

I think we make a large mistake when we try to psychiatrize violent and murderous behavior. It ignores the context we live in and gives social, historical, political and philosophical variables short importance. People kill people because they are people and sometimes being a person is a scary thing. Though not in fashion to believe, I think there is such a thing as evil and hatred unquestioned and hatred clothed as common sense is the door to that evil.

Far too often, far too easily it seems the only door open.

204 mass shootings in 204 days: What is going on?????

July 24, 2015 by

The most recent tragedy in Louisiana has took front and center stage in the most recent chapter of the mass murder marathon that is the United States. Louisiana is no stranger to mass murder. The latest tragedy was the 10th episode of mass murder in Louisiana this year. In the first 204 days of 2015 there have been 204 episodes of mass murder in the United States. 204 mass murders in 204 days. If anything is insane that is. 204.

You will not hear much about 204. You will hear more about his family seeking an order of protection and a psychiatric commitment and a bipolar diagnosis than anything else. Many people will see that as the cut and dried truth and tell you this was a failure of the mental health system and that tougher laws are needed to avert tragedy. The only thing more predictable than tomorrow’s tragedy is that someone will tell you if we had just listened to them it wouldn’t have happened.

I don’t know if this man had bipolar disorder or not and the people who will confidently tell you he did and that was the cause of this tragedy don’t know either. What seems sure is he had a lot of hate. And I think the first case of hate and racism being cured might be the first.

The problem with the no fault mental illness hypothesis is that it ignores the context that people live in. It makes the things he believes in, the values he holds, his political positions irrelevant or even a symptom of some supposed disease. Not only does it in a real way let him off the hook, it leaves us, society and culture off the hook. And we don’t deserve that.

Before bigotry can have wide commerce it must be clothed as somehow common sense. There are perhaps millions of people, thousands and thousands for sure, that believe that what this man believed was just common sense for anyone who can see and had the courage to speak up. And the thing about hateful violent things is that when those sentiments achieve a degree of “common sense” the likelihood of the being acted on go way up.

When you combine the likelihood of action with the tools necessary for that action the recipe for tragedy is real. Guns don’t kill people. People don’t kill people. People with guns kill people. Angry, rageful people with what they see as righteous or justified anger with guns are even more likely to kill people. I understand he got the gun legally. He didn’t even have to break the law to commit mass murder. It is so sad.

204. By the time you read this 205 may be upon us. Unless you live nearby you may not even immediately hear about this. It is close to normal now and further away from news.

I don’t believe we can cure murder. The Bible somewhere says you will, “know them by their fruits.” We have made it easy and even likely that we will hate those different than us. The ways people can credibly address their differences with others are seen as ineffective. We prize strength and not letting others push us around. We have a cowboy culture with no Wyatt Earp to insist we check our guns. And guns… Easy and everywhere.

The problem is not that we made the Louisiana shooter. We didn’t. But neither did we make him less likely.

204. 205 is next.


The core of the change process

July 22, 2015 by


From the archives

Originally posted on Hopeworks Community:

Why do some folks absolutely refuse to do things that are in their obvious best interest?  Why do other folks absolutely refuse to do stop doing things that are not in their best interest?  The mystery of mysteries….

Years ago I remember reading about something called the theory of inadequate justification.  The basic idea was really simple.  All of us are constantly trying to make sense of what we do.  We are always trying to find the ground to justify our behavior as sensible, or at worst, at least as necessary.  This theory says that people first look at external justification.  They did it because it paid money.  They did it because it got them something or prevented them from losing something.  In some way we try to justify our behavior by the consequences it brings.  We do things, or so we would like to believe, “because they make sense.”

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“The obstacles in the path are not obstacles…They are the path.”

July 22, 2015 by


From the archives….

Originally posted on Hopeworks Community:

“May you always remember the obstacles in the path are not obstacles…They are the path.”

Jane Lotter

The quote above ended the article I linked to a couple posts ago  “The nine essential habits of mentally strong people.”   It was an article with a lot of punch and a lot of wisdom.  If you havent read it I urge you to do so.  But for me the quote at the end really hit me between the eyes.

Much of our time is spent comparing how we are doing with how others are doing and one of the things we always compare are the obstacles in front of us and how they reflect on us.  We want our obstacles to be big enough to testify to our heroism and integrity, but not so big that they reflect poorly on us.  We like it best when our obstacles are out of…

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hippa… It ain’t what they say it is

July 18, 2015 by


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