Mind Fixers

I just finished listening to Mind Fixers last week and am looking forward to hearing the author, Anne Harrington, a history of science professor at Harvard, speak at our DBSA-Boston speakers series in 2020. (I’m the coordinator of the series.) I’ve recommended the book to several people, including R'el, my psychiatrist daughter at Bellevue.

The full title of Harrington’s book is Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness. It’s a thorough history of American psychiatry, from its roots in Europe through the 2010s. She chronicles the jockeying for position between the ‘neo-Freudians’, who advocate psychoanalysis and the psychiatrists who believed in a purely biological cause of mental illness. According to Wikipedia, neo-Freudians have been defined as "American writers who attempted to restate Freudian theory in sociological terms and to eliminate its connections with biology.”

I had a manic episode in the early eighties, when our first child was just turning two and our second was six months old. I had a more severe, more psychotic mania in 1995. When Jim could no longer recognize me, and feared for our children, he signed me into a locked psychiatric unit. When I emerged I was convinced to take psych meds, told that my episodes would get more frequent (than every twelve years) and more severe. Seven years later, against medical advice, I stopped the psych meds, cold turkey, with predictable results: another ambulance ride to the same psych unit. Since then, I’ve taken meds for sixteen years. I don’t like it, but don’t see a viable alternative.

I’m an active member of DBSA-Boston, a local chapter of the national Depression Bipolar Support Alliance and have facilitated support groups about once a week for nearly ten years.

Quite a while ago, based on my own experience and my observations in DBSA groups, I rejected the ‘chemical imbalance’ view of mental illness. As far as I can tell, and as Harrington states persuasively, no one knows the deep cause of mental illness. There’s no blood test, no diagnostic brain scan, just a list of symptoms in the DSM (Diagnostic and Statistical Manual of Mental Disorders). It’s rather like diagnosing an illness by the type of fever produced (that's a effective simile I read). And why do the meds fail so many, especially those who are depressed? Why does cognitive behavioral therapy (CBT) work as well as anti-depressants? Why are the same classes of drugs prescribed for different types of mental illness?

I’m deeply grateful to psychiatry and the efforts of many professionals (including my daughter and my deceased father-in-law) to alleviate pain and suffering. I have been psychotically manic three times in my life. Since I was first prescribed psych meds, in 1995, I have only been severely manic one time, when I stopped taking them (against medical advice). Much of what I have accomplished in my life since 1995 would not have been possible without them.

I highly recommend Mind Fixers by Anne Harrington. And I’d love to hear what you think about it.

Worst-case Scenario

I was first introduced to cognitive behavior therapy (CBT) by David Burns, in his best-seller, Feeling Good, where he identifies10 cognitive distortions. I practice all of them on a regular basis, despite years of 'understanding' their negative effects. Fortune-telling, a subset of Jumping to Conclusions is perhaps my favorite.

Last week I spent a beautiful spring day in New Jersey with my sister Maggie, who lives in southern California. We visited our disabled brother, Mike, at a LTACH (Long Term Acute Care Hospital) in Newark, then drove 22 miles south to our parents’ grave in Perth Amboy, provincial capital of the colony of New Jersey. We planned to meet another brother (we have four), Carl, for supper at Ruthie’s Bar-B-Q and Pizza, in Montclair. Susan had told Maggie that parking was tight. As I drove the 26 miles north on the Garden State Parkway, I struggled to talk myself down. To avoid rush-hour traffic, we planned to arrive at Ruthie’s 2 hours before our date and take a long walk in the lovely township of Montclair. If we parked in their parking lot so early, would someone from the restaurant notice us walking away and call a tow truck? My attempts to quiet my mind failed, so as we got off the parkway, I admitted my fears to Maggie.

“You always go for the worst-case scenario, Mary.”

I was taken aback. I recognize (sometimes) my modus operandi, but I didn’t realize I was so transparent about it.

As it turned out, there is no parking lot at Ruthie's and we parked on the street. Checking my GPS, we found Eagle Rock Reservation and drove to the 9/11 memorial with it's stunning view of the NYC skyline.

Back at Ruthie's, we again parked just across the street and enjoyed a lovely supper with Carl before I headed back up to Lexington.

What's your quirk that is obvious to everyone around you? (or at least to those who love you)?