Zen Dharma Schizophrenia Mental Health Recovery, Hearing Voices Coping

Hearing Voices Coping, Zen Dharma Schizophrenia Mental Health Recovery Hearing Voices Coping 5 Responses »

Jul 302011

Zen Dharma Schizophrenia Mental Health Recovery, Hearing Voices Coping

Hearing voices is a common phenomenon.

Aaron Beck MD cites research that 5% of the population hears voices but it only interfers with the daily lives of 1% hearing them.

It is thus inadvisable to suggest that “hearing voices” alone is a symptom of an “illness.”

Schizophrenia mental health recovery depends on coping or transforming this phenomenon only if it is interfering with daily life.

For those of us who have been or are bothered by “hearing voices” enough to interfere with daily life there are many ways to deal with them. In a series of blogs we will discuss several. Here we shall discuss a basic technique for schizophrenia mental health recovery. Later more.

“Voices” “heard” are thoughts.

As a Zen Buddhist once said to me, “Whether they are your thoughts or someone else’s thoughts, they are just thoughts.” Realizing this helps one maintain balance in the face of our own mind. Such balance is the basis of schizophrenia mental health recovery.

Another Zen saying,”Just because a voice is disembodied does NOT mean it is wise.” Treating “voices” like any other set of thoughts may be difficult but will help schizophrenia mental health recovery.

Something which may assist perceiving “voices” as just thoughts if you are bothered by them is a point made by Aaron Beck MD. Aaron Beck points out that “hot thoughts” transform into “voices”. “Hot thoughts” in “cognitive behavioral therapy” are emotionally loaded thoughts. When emotionally loaded thoughts present themselves forcefully and appear “real”. Realizing this again helps me gain balance and experience “voices” as just thoughts and assists with schizophrenia mental health recovery.

“Voices” are generally NOT commands, often called command hallucinations. This notion of commands is a very misleading stereotype on the media. The media is also very misleading about schizophrenia mental health recovery. On this see, What Is Actual Schizophrenia Recovery Rate Even when on the rare occasions that “voices” command something most of the time the commands are not followed by those hearing them. Chadwick and Berchwood point out “Without fail, voices believed to be malevolent provoked fear and were resisted…” The Omnipotence of Voices I: A Cognitive Approach to Auditory Hallucinations So schizophrenia mental health recovery is not hindered by a phenomenon which is unchangeable. Voices can be successfully coped with. They are not somehow immutable and written in our genes or brains.

The impression that command hallucinations are common comes principly from an overgeneralization of research by Lee who worked with a very small sample (53) skewed to this phenomenon. The work of Marius Romme,PhD cited by Beck shows that voices are rather common and coped with well by many.

Romme is a key researcher on schizophrenia mental health recovery in Europe and his contribution on the phenomenon of “voices” is key.

Romme says “The form and the content of chronic auditory hallucinations … compared in three cohorts, namely patients with schizophrenia, patients with a dissociative disorder, and nonpatient voice-hearers was not significantly different between the three groups. The subjects in the nonpatient group, unlike those in the patient groups, perceived their voices as predominantly positive: they were not alarmed or upset by their voices and felt in control of the experience. In most patients, the onset of auditory hallucinations was preceded by either a traumatic event or an event that activated the memory of earlier trauma.” In other blogs we shall deal further with this material. Romme found a rich range of “voices” not just command hallucinations. Auditory Hallucinations: A comparison of patients and non-patients. Romme’s work is cited as well as many other research papers on “voices” at Intervoiceonline.org see also for peer mutual support Beck and the data he presents help as he says normalize the hearing of ‘voices’ which Beck sees as a key element in schizophrenia mental health recovery.

“Hot thoughts” are at times so laden with emotion that they are heard as a voice outside one’s self, as if “out loud.” Often this seems to happen against background noise and one’s hot thoughts seem to be “read into” this background noise. These things can be learned and do not have to dominate a persons mind. They can recede into the background and schizophrenia mental health recovery happens, happens quite often.

Usually the “hearing of voices” is within one’s mind. “Mind reading” is an example of “voices” within one’s mind. One thinks one can “hear” someone elses thoughts. This is called thought insertion. Or one can think someone else is reading one’s thoughts. This can be terrifying as we think many things we would not like others to know.

Schizophrenia mental health recovery is aided by understanding thoughts as “hot thoughts” expecially in instances like this.

It might be pointed out that there are very famous people who “talk to spirits” or make a living hearing “voices”. People like Sylvia Brown, or James Van Praagh. Millions of people are entertained by this. There are books in stores like Barnes and Nobles and Borders teaching thousands upon thousands of people to channel.

But somehow people limit their perceptions when it comes to those labeled even though research consistently shows those labeled with schizophrenia no more dangerous than anyone else. In the presence of alcohol people with schizophrenia are dangerous but LESS so than someone without a psychiatric label. I will post on this in another blog. This kind of selective perception promoted so by the media is a major block to schizophrenia mental health recovery.

This block is due to the internalization of these kinds of destructive stereotypes as well as the blatant descrimination due to them.

I myself many years ago had a great fear of this “mind reading” phenonemon. It was a feedback loop. Fear brought on voices. Voices drove fear and thus more voices. What relieved me of this fear of others “reading” my mind happened more than 25 years ago. My wife an I were living with a Sufi in New York City who had taken us in off the streets while I looked for a job. He was just entering the kitchen where my wife and I were seated chatting. I was thinking a question. My Sufi friend answered the question. I felt comfortable around him and being a Sufi I knew he would not freak out. So I asked, “I was just thinking that. Did you know I was thinking about the same thing?”

He answered, “No things like that are ‘just in the air.”

So if “just in the air” then no one need read my mind to pick up on thoughts about the same thing. Hence I need not fear another knowing my thoughts. This ended a feedback loop of “mind reading”, embarrassment and fear at someone knowing my thoughts driving more “mind reading” and so on. Schizophrenia mental health recovery seemed much more possible when I realized this.

Once a cognitive underpinning of things like “mind reading” has been challanged then other methods are more viable like interferring with subvocalization. Subvocalization is the slight movement of our throat muscles when we think. Thinking is thus a form of behavior which can be changed.

Zen Dharma Recovery is thus applied to schizophrenia mental health recovery as it is with anxiety, the various forms of mania and depression. One can think non-thinking, the basic Zen Dharma Recovery art.

When “hot thoughts” as voices are powerful enough to interfer with daily life one needs a way to be relieved. “Hot thoughts” as “voices” are like all thoughts subvocalization. One needs to be mindful of the phenonemon. Zen Dharma Recovery is based on this. Once mindful one can do something. Humming a tune will interfer with them, slow them down, since it interferes with subvocalization. For some it brings complete relief. For other a little. For a few none at all.

For optimal effectiveness the cognitice underpinnings of “voices” needs to be challanged as I said earlier. This challanging need not be that the voices are unreal. Rather it can be the sorts of things that the Zen students or the Sufi had told me. If one reads the scientific literature on “voice” hearing one will see that voices are given credibility not just due to thinking them real but due to the “authority” given them. The Zen and Sufi wisdom I have heard over the years challanges the “authority” of the “voices”. Schizophrenia mental health recovery is enhanced when the “authority” of “voices” is undercut. Then a technique like humming is much more effective.

Zen Dharma recovery is mindfulness and letting go of thoughts or thinking non-thinking. It allows freedom and can be a basis of schizophrenia mental health recovery.

Iistening to music is another way to let go. In this method one can more easily pay attention to music instead of the noise of “voices” in one’s head if the voices have less authority. Less authority, less interest, the more easily distraction will work.
It is also easier to directly challange the “voices”, to say “go away” successfully.

Of course as we have discussed in other posts on this page, ujaya breathing can also bring relief when one is not in a social situation where one can hum.

Here is a brief description of ujaya breathing once again. See also Zen Not-Knowing Ujaya Breath Supports Anxiety Recovery and Bipolar Mental Health Recovery Anxiety Mania

Just very slightly close your throat muscles and breath without effort otherwise. A simple way to do this is to silently say “hum” to yourself as you breath in an otherwise unrestricted way. In yoga, full ujaya breath is much more controled. Silently say “hum” instead of counting. Or count silently with the throat slightly constricted or slightly closed.

We had a yoga instructor in our training a while back. She taught ujaya breathing as follows. Imagine a very small soda straw in one’s throat. Close the throat muscles on the soda straw holding it very gently. This of course allows the throat to close a little. Breath will be slightly audible doing this. One can count: one on out breath, two on in breath, three on out breath, four on in breath, five on out breath, six on in breath, seven on out breath, eight on in breath, nine on out breath, ten on in breath. begin again, one on out breath, two on in breath and so on. One can count with a slightly tightened throat instead of saying “hum”. These methods will assist schizophrenia mental health recovery and allow more consistent attention to the tasks of everyday life, to focusing on the task at hand in one’s daily life.

What ever mindfulness or breath method you chose, practice from two minutes to twenty five minutes a day in a comfortable position. Consistency is more important than how long you do it each day. When you need the skill it will be there.
There are many other ways to deal with bothersome “voices” to aid in schizophrenia mental health recovery some of which we shall discuss in other blogs.

So to summarize:
Schizophrenia mental health recovery happens frequently.

Schizophrenia mental health recovery is based on research.

Schizophrenia mental health recovery is aided by understanding the research of Aaron Beck, Marius Romme and others on “voices”.

Schizophrenia mental health recovery can be supported by Zen Dharma Recovery.

Some books of interest.
This first book from The Center for Psychiatric Rehabilitation has a chapter by Dr. Courtenay Harding with a summary and analysis of 10 longitudinal outcome studies of schizophrenia demonstrating that it is not a degenerating biological disease but has rather high recovery rates. She trains at the Coalition of Behavioral Health Agencies in New York City.

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Perverse financial incentives driving medicaid costs and deepening disability.

A Set of Perverse Financial Incentives Driving Medicaid Costs Deepening Disabliity, Schizophrenia, neuroleptic medication, mortality 8 Responses »

Jul 172011

The perverse financial incentives driving medicaid costs and deepening disability.

An incident in a large metropolitan area of Colorado. A medicaid client is admitted to a hospital. He is missing both his legs. He uses a wheel chair. A bit over weight but otherwise healthy. Not obese. No history of any mental illness and no history of psychosis.
He is admitted for routine surgery.
The surgery requiring anesthesia goes well.

This is a billable service under medicaid.

He awakens in the post op recovery room confused and disoriented. He seems to be hallucinating. This is called post operative psychosis. The usual treatment is to wait a good long time, to discharge under care. This person had parents capable of caring for him with whom he lived.
In this medicaid case this was NOT done. The doctors did not wait. He was given an atypical antipsychotic. And again no history of psychosis. or any other mental diagnosis.

The prescribing of the atypical and the drug itself are billable under medicaid.

He quickly develops out of control diabetes. A common side effect of the atypical class of drugs is diabetes along with obesity, high colesterol and high blood pressure. It is not always so fast developing. But it sometimes is. The metabolic side effects are a principle reason people given them and other psychiatric drugs die 25 years younger than average. He is taken off the atypical successfully. it takes time to do this. Cold turkey can cause further problems.

But the longer time to detox is billable to medicaid.

The patient now is kept for a longer time in the hospital for stabilization of his blood sugar.

This is a billable services under medicaid.

The patient now needs special care to be discharged. Disease management must be found.

This is a billable service under medicaid case management.

The patient is discharged and under disease management care.

This is a LONG TERM billable service under medicaid.

The various drugs for diabetes cause weight gain. They make diabetes chronic. The patient was missing legs. He was otherwise self sufficient. Now he will probably be over weight and chronically diabetic. All of course billable under medicaid. He is now likely to develop additional health problems due to being over weigh, like pressure sores which for a diabetic are very expensive to treat.

And this is even more billing under medicaid.

And in this case in Colorado metropolitan area one company owned by the hospitals and the large mental health provider and other medical and mental health entities collects ALL the medicaid billing for each of the medicaid billable services for this unfortunate young man.

This is a perverse financial incentive driving the deepening of disability for many many medicaid and probably medicare clients.

This is a big money maker for managed care companies who exploit medicaid and medicare and the patients treated by them.

The senerio as is, is bad enough but it gets worse if the contract is an “at risk” contract for both physical and mental health.

Why does it get worse? The industry standard profit for an at risk contract in medicaid is usually 6%. But the 6% is calculated on the total revenues. The total revenues are driven much higher by multiple services as in the case of the unfortunate young man we describe. And thus the 6% is on a much larger base. The amount is considerably higher than just an operation. Hence much larger profits the more patients can be multiply billed for medical diseases caused by improper use of atypicals .

Thus managed care in medicaid is a death and disability machine.

And it may be in private insurance.

What is the probable cost?

Veterans Administration senior psychiatrists say on co-occurring medical costs from proper atypical use in the VA is 30% lower per patient.

And the VA care is considerably better. People are generally not disabled so severely by perverse financial incentives. I am a volunteer researcher with the VA mental health QUERI committee which sets research policy.
On psychiatric usages Dr Sederer Medical Director of the Office of Mental Health of New York State has said his principle cost in medicaid is co-occurring medical costs from the multiple use of atypicals. There are no incentives to take people off of atypicals they are already on. So many are on 3 or 4. Each additional atypical adds high risk of metabolic side effects like diabetes or obesity but does not add treatment benefit except in very rare cases.
Another common and illegal problem is the off label use of atypicals for sleep and anxiety. FDA has guidelines not often followed.

Off label use is use NOT for psychosis. It still causes diseases. And drives up costs. And billable medicaid services and profits.

Is this consciously done? Very angry managed care psychiatrists, physicians and senior executives have said and written to me: “I don’t make a cent on this. I don’t get paid to do this.” I pointed out as politely as I could that market incentives don’t operate consciously. But as long as money is made no one looks. It is only when there is a loss that someone looks. However, regional executives of mco’s are rewarded for sending the quarterly profit margin to corporate offices and that is usually calculated as a percent of revenues. As I have said revenues are driven up by co-occurring medical billing for diseases caused by what happened to this young man. By the improper use of atypicals.

The solution? One pot of money. All medical and mental expenses come out of it. NO SEPARATE BILLING for each service caused by the addition of services because of medically caused co-occurring medical conditions. The managed care company or large provider is responsible for all costs of care for each patient for out of same pot of money. This is REAL capitation. NOT phony capitation with lots of hidden perverse financial incentives. And safe guards against not admitting or dropping patients. And NO pre-existing conditions exclusions.The industry would staighten out over night.

Over night medicaid and probably medicare costs would drop and over night fewer people would have their manageable disabilities turned into expensive life draining unmanageable disabilities for which you and I pay unnecessarily.

Is accountable care actually going to do this? Perhaps if it is done properly. That is why insurance and managed care companies hate Obama. Perhaps accountable care will correct this but it will depend on the billing mechanisms more than on the pretty sounding rhetoric. However it is only a partial fix. The basic problem is that at present the separation of acute care and long term care will continue in accountable care to drive the kind of perverse incentives I have described here. If one causes a disease say by off label use of atypicals in acute treatment then one can make money in the long term treatment of the disease caused. But at least the perverse incentives are fewer. Again that is why insurance companies hate Obama. Off label use is not recommended by the FDA and most states have rules to use them. These rules include generally eliminating “other products”. This is generally not done in my experience.

The following material is being developed as part of a UCLA pilot being co-directed by Ed Knight, PhD,CPRP. Alex Young MD is principle investigator. On recovery see Bipolar Mental Health Recovery Patterns
Zen Dharma Schizophrenia Mental Health Recovery Hearing Voices Coping
Mindfulness Meditation Enhances Depression Mental Health Recovery Life Style
Zen Not Knowing Ujjayi Breath Supports Anxiety Recovery

Insurance company influence on the House of Representatives and Senate needs to stop. It disables people more than they are. AND it drives medicaid costs sky high.

Medicaid does NOT have to cost a fortune and drive up costs with perverse financial incentives.

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What Is Actual Schizophrenia Recovery Rate? Revised Jan. 21, 2011 | schizophrenia

What Is Actual Schizophrenia Recovery Rate 10 Responses »

Apr 142011

90% schizophrenia recovery/significant improvement rate researcher Dr. Harding says. That she said is the accurate understanding of her data from the Vermont study. The full range of follow up data is available in the table below on this page.

A person receiving a diagnosis or label of schizophrenia loses hope and enters a state of anguish caused by the treatment experience of meaninglessness, hopelessness and helplessness. Much of this hopelessness for people psychiatrically labeled is not due to a disease but to the mental health systems designed to treat it.

Pat Deegan PhD, a psychologist diagnosed with schizophrenia,, defines recovery from serious mental illness as “Rediscovering meaning and purpose after a series of catastrophic events.” When someone becomes labeled seriously mentally ill especially with schizophrenia, he loses not only sanity (albeit temporarily for the great majority people), but also position in society, income, friends and, in many cases, family and possessions.

Mental health systems are set up for maintenance and communicate that life is without hope of significant accomplishment once serious mental illness like schizophrenia has set in. Yet, experience shows that recovery from schizophrenia is possible. See Recovered Professionals Labeled with Schizophrenia

Experience and research teaches that with expectations of recovery and proper support, people can regain their lives and their independence.

Recovery theories are grounded in longitudinal studies of schizophrenia. According to Nancy Andreasen, MD, schizophrenia is considered probably the cruelest and most devastating of all the persistent mental illnesses. Dr Andreasen also has said that her data point to brain shrinkage due to anti-psychotic medications and NOT to any underlying biology of schizophrenia. ( Click to see NY Times article on schizophrenia where she says: the more drugs you’ve been given, the more brain tissue you lose.)

Is this true that this is such a devastating disease? Perhaps as a social label. The label of schizophrenia is social death sentence.

But is there any scientific evidence that schizophrenia is a degenerative biological disease as Emil Kraepelin said in the 1920′s? Kraepelin’s deputy Rudin became a Nazi collaborator and his degenerative biological disease model became the basis of the extermination of people labeled by Hitler as “useless eaters”

[ On Kraepelin's background see: Alternatives Beyond Psychiatry]
( American mental health programming remains largely based on this degenerative disease model even without evidence to substantiate it. Aaron Beck MD in his book on Schizophrenia summarized the lack of evidence. He reports there are no agreed upon repeated anatomical or phyciological differences between drug niave people labeled with schizophrenia and those not so labeled. As for genetic evidence Beck summarizes that there are as yet no genes proven to be associated and that if you take the best candidates they only account for from 6% to 15% of the cases.
Evidence which is not replicable is not really evidence in science. But one time statistical associations which are not repeated findings are blasted all over the internet by groups like The Treatment Advocacy Committee (which is paid for by the largest psychiatric drug experimental trials company in the world). Other “advocacy” organizations who receive a majority of their funding from psychiatric drug manufacturers also blast unreplicated or unrepeated “research”. Mental Health First Aid is also being spread. It has very stereotypical information which is scientifically inaccurate especially about schizophrenia. (I am preparing a paper for a scientific journal on this issue.) A description of this mental system programming which is based on ritual shaming is found at Mental Health Rituals, Disempowering, Empowering Schizophrenia is the most ritually shamed label. Perhaps the worst public ritual shaming is carried on by E.Fuller Torrey in the face of overwhelming evidence of the inaccuracy of his statements.
This question therefore, serves as a touchstone for recovery based models of treatment.

So how many people labeled with schizophrenia actually recover? This data is most often ignored.

There are now over 12 longitudinal studies of schizophrenia and the average over them all is 63%.

Schizophrenia Recovery Research

Study	Sample Size	Average Length Years	Percent Recovered or Signicantly Improved
M. Bleuler 1972 to 1978 Switzerland	208	23	53-68
Hinterhuber 1973 Austria	157	30 apprx	75
Huber et al 1975 Germany	512	22	57
Chiompi and Muller 1976 Switzerland	289	37	53
Kreditor 1977 Lithuania	115	20+	84
Tsuang et al 1977 USA	200	35	46
Marinow 1986 Bulgaria	280	20	75
Harding et al 1987b 1987c USA	269	32	62, 68
Ogawa et al 1987 Japan	140	22.5	56
Desisto et al 1995a 1995b USA	269	35	49
Marneros et al 1992	148	25	58
Isos ICD 10 Sz Only Incidence	502	13 to 17	67
Isos ICD 10 Sz Only Prevalance	142	26	63

Here we are correcting serious mis-interpretations of Harding’s data on recovery from schizophrenia.

Dr. Harding’s data are all the more powerful because she was studying the bottom 19% in the functional hierarchy in a large state hospital. Some of the people with schizophrenia in her study had regressed to speaking in animal like sounds. Most had been in the institution for 10 or so years, many had been in and out repeatedly. The cohort is the least functional ever studied longitudinally in world literature on schizophrenia.

Nevertheless, of this bottom 19%, 62% to 68% fully recovered or significantly improved. The recovery happened when they were taken from the very debilitating hospital environments and taught the skills and supported to live in the community at a great tax savings.

Given this:

IN THIS STUDY IF ONE DOES THE MATH. THE ACTUAL RECOVERY FROM SCHIZOPHRENIA is 90%.

Can mental systems do something to raise rates? Yes. Support people labeled in setting meaningful goals and teach skills. Skills to “managed” “symptoms”. Skills to do a meaningful job. Skills to connect. This is what Dr. George Brooks did in Vermont in the early 50′s. It was this group Courtenay studied.

Two of the longitudinal studies on which the recovery model is based were done by Courtney Harding, PhD. Dr. Harding’s definition of recovery has four criteria:

having a social life indistinguishable from your neighbor
holding a job for pay or volunteering
being symptom free, and
being off medication.

Dr. Harding’s data in a recovery oriented system in Vermont point to recovery or significant improvement in 62% to 68% of people studied. Dr. Harding’s data are all the more powerful because she was studying the bottom 19% in the functional hierarchy in a large state hospital. Some of the people in her study had regressed to speaking in animal like sounds. Most had been in the institution for 10 or so years, many had been in and out repeatedly. The cohort is the least functional ever studied in world literature on schizophrenia. Nevertheless, of this bottom 19%, 62% to 68% fully recovered or significantly improved. Half of the cohort of 62% fully recovered meeting all four of Dr. Harding’s recovery criteria in this longitudinal study and half met three out of four criteria, usually continuing to take medications while meeting the other criteria. In other words half the 68% of the BOTTOM 19% were no longer on meds successfully without relapse.

In a companion longitudinal study to her Vermont study, Dr. Harding studied a system in Maine oriented to maintenance instead of recovery . Patients were considered incapable of accomplishing anything like holding jobs or volunteering. They were expected to be in and out of the hospital for the rest of their lives and basically live as totally disabled. In this system, in spite of the adverse expectations, people recovered or significantly improved at a rate of 49%. Vermont’s 62% to 68% recovery rate was significantly better. Those who had been studied in Vermont were significantly more likely to have lower symptoms and to work or volunteer. This points to the healing effects of meaningful activity, which the individual chooses to pursue for schizophrenia. see also Schizophrenia, neuroleptics,mortality.
On Tools for Recovery see Zen Dharma Recovery Mental Health Video And First Attempt Transforming Anxiety
Listen to Madness Radio Interview. Buddhist Meditation and Schizophrenia On bipolar diagnoses see Bipolar Mental Health Recovery Patterns
Some books of interest.
This first book from The Center for Psychiatric Rehabilitation has a chapter by Dr. Courtenay Harding with a summary and analysis of 10 longitudinal outcome studies of schizophrenia demonstrating that it is not a degenerating biological disease but has rather high recovery rates. She trains at the Coalition of Behavioral Health Agencies in New York City.

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Icarus Project members helped my stay out of an emergency room when I had a non-psychiatric emergency. In ER’s labeled people are often mistreated.
The Icarus Project

Will Hall, psychotherapist from Portland Oregon(website WillHall.net):

Harm Reduction Guide to Coming Off Psychiatric Drugs

Schizophrenia is NOT hopeless!!!

The $139 model of Kindle gives you access to internet where wifi is free like McDonald’s and is less than a computer.

Ralph and Corrigan reach the same conclusion that the actual recovery rate is 90% using a different method which gives further verification.

On the unnecessary and costly tragedy of “hospitalization”.

Transforming mental health systems to recovery.

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Schizophrenia, neuroleptic medication, mortality

Schizophrenia, neuroleptic medication, mortality 2 Responses »

Apr 142011

There is to date no other (Nov 2010) study which contradicts these findings on schizophrenia mortality being mainly due to medications.

Other studies of mortality have significantly different research designs and are not addressing the issues addressed in this study, including other studies from Finland. The issue of whether mortality is mainly due to medications used or life style issues. One troubling development is that now mental health centers prescribe these drugs more often than needed, in much higher doses than needed and with multiple antipsychotics. Dr.Sederer, the Medical Director of the New York State Office of Mental Health issued a report recently that the co-occuring medical costs due to this (and the much more controvercial off label use of these drugs) is New York’s greatest medicaid cost. And they then charge for disease management for side effects like obesity, diabetes, and so on. This of course makes it very profitable. Companies which do both disease management and mental health care make the most this way.

So called “integrated care” is driving this abuse which is disabling and killing people 25 years younger than average, most especially people labeled with schizphhrenia. IT ALSO DRIVES MEDICAID COSTS SKY HIGH.

One should note GETTING OFF NEUROLEPTICS without medical support or quickly will most assuredly cause psychosis. The brain adjusts to the presence of drugs and produces more dopamine than otherwise. Also it should be noted that in NO study has it been shown no one needs medications. Some people profit from them.

The study on neuroleptics and mortality is
Schizophrenia, neuroleptic medications and mortality. Matti Joukamaa, Markku Heliovaara, Paul Knekt, Arpo Aromaa, Raimo Raitasalo, Ville Lehtinen, British Journal of Psychiatry (2006), 188, 122-127.

There is an excess of death from natural causes among people
with schizophrenia treatment with neuroleptics. People so labeled were studied for their prediction of mortality in a representative population sample of 7217 Finns aged years. A comprehensive health examination was carried out at baseline. Schizophrenia was determined using the Present State Examination and previous medical records.

Adjusted for age and gender, the relative mortality risk between those with schizo- phrenia and others was 2.84 (95% CI 2.06^3.90), and was 2.25 (95% CI1.61^3.15) after further adjusting for somatic diseases, blood pressure, cholesterol, body mass index, smoking, exercise, alcohol intake and education.

There is an urgent need to ascertain whether the high mortality is attributable to the disorder itself or the antipsychotic medication.

The authors Declaration of conflicts of interest.

One should note to get such significant results from a small sample shows the power of the statistical association. It is the only study with controls for lifestyle that i know of. Most don’t and therefore have attributed early death to lifestyle. It is also going to be argued that the early death is a result of a “disease” called ” schizophrenia” Harrow’s data on schizophrenia call into question the relationship between medications and schizophrenia recovery. Factors Involved in Outcome and Recovery in Schizophrenia Patients Not on Antipsychotic Medications: A 15-Year Multifollow-Up Study Aaron Beck’s summary of the lack of biological evidence also must be considered. He points out that in 90 years of research there are no consistent differences found anatomically or physiologically between people labeled with schizophrenia and those not labeled with schizophrenia. He also points out that there are no genes definitely linked to schizophrenia. Further if one choses the best candidates they only account for from 6% to 15% of the data. (Schizophrenia: Cognitive Theory, Research, and Therapy)

This hardly constitutes a biological basis for an underlying “disease” which can account for early death. H.Walter Heinrich in his book In Search of Madness concludes there is no evidence for the dopamine hypothesis. Indeed in his meta study covering all areas of research he finds only weak evidence for everything about scchizophrenia. (In Search of Madness: Schizophrenia and Neuroscience)
The original work on dopamine metabolites in spinal fluid showed no difference between people labeled and not drugged and people not labeled and of course not drugged. The work of Malcolm Bowers, Robert Post and the meta study of John Haracz “The dopamine hypothesis: an overview of studies with schizophrenic patients,” Schizophrenia Bulletin 8 (1982): 438 -58 has never been disproven. Their work shows there is no definitive evidence for the dopamine hypothesis. All subsequent speculation on dopamine is vitiated. It is now impossible to study non drugged labeled people. About 6 years ago NIMH sought but could not find non drugged labeled people. There are no ways in which early death could be biologically accounted for by a biology of underlying disease. There are however clear ways in which neuroleptic drugs can account for early death since we know they cause diabetes and also changes in the way people metabolize fat and hence irreversible weight gain. There are non-drug and low dose drug researched treatments. Schizophrenia does not have to have this death rate.

Zen Dharma Schizophrenia Mental Health Recovery, Hearing Voices Coping

Buddhist Meditation and Schizophrenia

Recovered Professionals Labeled With Schizophrenia

The brain adjusts to the presence of medications. Getting off medications quickly without medical support is very likely to cause psychosis from rebound effects

Books of interest.

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Professionals Labeled with Schizophrenia 1 Response »

Apr 142011

This link to an article on professionals labeled with schizophrenia does not fully relate my position on medications. I have essentially the same view as Lauren Mosher, MD , Jaakko Seikkula, PhD. and many others. Neuroleptics are needed in small amounts and only for a few people and for some only usually for a time. A few people need them longer than others and occasionally for life.

The research evidence from longitudinal studies shows half of those in recovery from schizophrenia not on life time neuroleptics.

see What is Actual Schizophrenia Recovery Rate
Many more people recovery than is every publicized. Clinicians generally see people at their worst and when people labeled with schizophrenia begin to do better they generally leave the system. And due to stereotyping and prejudice (called stigma) they do not generally publically speak.

Thus what researchers call “the clinicians illusion” arrises.

The vicious stereotyping in the media of people labeled with schizophrenia inspite of ALL legitimate research showing that those labeled with “mental illness” are no more dangerous average forces people not to speak. Dangerousness is increased by alcohol and drugs, not “mental illness” and not schizophrenia. Alcohol use by anyone is the strongest predictor of dangerousness. However groups seeking to change policy pursue agendas of media smearing purely for political purposes.

Any group can be labeled and stereotyped in the media like this. This same thing was done to Viet Nam vets during and after that unpopular war.

The media played up the few incidents of violence and very unfairly labeled them. In American history African American men were labeled as rapists by blasting every incident unfairly across all the media.
Fred Freze the principle author along with me (Ed Knight, PhD, CPRP) and Ellyn Sachs wrote the following article to demonstrate the number of us who recover and have professional degrees who are labeled with schizophrenia. Fred has gone on now to collect many more who have both the schizophrenia label and an MD, PhD, or law degree as Ellyn.

Recovered Professionals Labeled with Schizophrenia

Buddhist Meditation and Schizophrenia

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Professor Ed

Zen Dharma Schizophrenia Mental Health Recovery, Hearing Voices Coping

Aaron Beck MD cites research that 5% of the population hears voices but it only interfers with the daily lives of 1% hearing them.

Schizophrenia mental health recovery depends on coping or transforming this phenomenon only if it is interfering with daily life.

As a Zen Buddhist once said to me, “Whether they are your thoughts or someone else’s thoughts, they are just thoughts.” Realizing this helps one maintain balance in the face of our own mind. Such balance is the basis of schizophrenia mental health recovery.

Romme is a key researcher on schizophrenia mental health recovery in Europe and his contribution on the phenomenon of “voices” is key.

Schizophrenia mental health recovery is aided by understanding thoughts as “hot thoughts” expecially in instances like this.

He answered, “No things like that are ‘just in the air.”

Zen Dharma Recovery is thus applied to schizophrenia mental health recovery as it is with anxiety, the various forms of mania and depression. One can think non-thinking, the basic Zen Dharma Recovery art.

Zen Dharma recovery is mindfulness and letting go of thoughts or thinking non-thinking. It allows freedom and can be a basis of schizophrenia mental health recovery.

Of course as we have discussed in other posts on this page, ujaya breathing can also bring relief when one is not in a social situation where one can hum.

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Perverse financial incentives driving medicaid costs and deepening disability.

This is a billable service under medicaid.

The prescribing of the atypical and the drug itself are billable under medicaid.

But the longer time to detox is billable to medicaid.

This is a billable services under medicaid.

This is a billable service under medicaid case management.

This is a LONG TERM billable service under medicaid.

And this is even more billing under medicaid.

This is a perverse financial incentive driving the deepening of disability for many many medicaid and probably medicare clients.

This is a big money maker for managed care companies who exploit medicaid and medicare and the patients treated by them.

Thus managed care in medicaid is a death and disability machine.

Veterans Administration senior psychiatrists say on co-occurring medical costs from proper atypical use in the VA is 30% lower per patient.

Off label use is use NOT for psychosis. It still causes diseases. And drives up costs. And billable medicaid services and profits.

Over night medicaid and probably medicare costs would drop and over night fewer people would have their manageable disabilities turned into expensive life draining unmanageable disabilities for which you and I pay unnecessarily.

Insurance company influence on the House of Representatives and Senate needs to stop. It disables people more than they are. AND it drives medicaid costs sky high.

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What Is Actual Schizophrenia Recovery Rate? Revised Jan. 21, 2011 | schizophrenia

Experience and research teaches that with expectations of recovery and proper support, people can regain their lives and their independence.

Is this true that this is such a devastating disease? Perhaps as a social label. The label of schizophrenia is social death sentence.

So how many people labeled with schizophrenia actually recover? This data is most often ignored. There are now over 12 longitudinal studies of schizophrenia and the average over them all is 63%.

Schizophrenia Recovery Research

Nevertheless, of this bottom 19%, 62% to 68% fully recovered or significantly improved. The recovery happened when they were taken from the very debilitating hospital environments and taught the skills and supported to live in the community at a great tax savings.

Given this:

IN THIS STUDY IF ONE DOES THE MATH. THE ACTUAL RECOVERY FROM SCHIZOPHRENIA is 90%.

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Schizophrenia, neuroleptic medication, mortality

There is to date no other (Nov 2010) study which contradicts these findings on schizophrenia mortality being mainly due to medications.

So called “integrated care” is driving this abuse which is disabling and killing people 25 years younger than average, most especially people labeled with schizphhrenia. IT ALSO DRIVES MEDICAID COSTS SKY HIGH.

The brain adjusts to the presence of medications. Getting off medications quickly without medical support is very likely to cause psychosis from rebound effects

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Recovered Professionals Labeled, Schizophrenia | schizophrenia

The research evidence from longitudinal studies shows half of those in recovery from schizophrenia not on life time neuroleptics.

Thus what researchers call “the clinicians illusion” arrises.

Any group can be labeled and stereotyped in the media like this. This same thing was done to Viet Nam vets during and after that unpopular war.

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Mental Health Recovery Blogs

So how many people labeled with schizophrenia actually recover? This data is most often ignored.

There are now over 12 longitudinal studies of schizophrenia and the average over them all is 63%.