Friday, August 28, 2009

Loss of Cell Phone, Dignity

Dear Sir,

Thank you so much for finding my cell phone, wherever it was that I dropped it. I really, really appreciate it.

Unfortunately, the email you sent telling me that you found my cell phone only listed your phone number. And I can’t phone you, because you, sir, have my cell phone.

I know you, like most normal, functional adults, have things like cars and landlines. But I am not a normal, functional adult. I am barely a strange and incompetent adult. And I do not have a landline, only a cell phone, and you have my cell phone. And so I could not call you until the next day, at work, during a quiet moment in the afternoon.

You see, I work in a drop-in centre for the mentally ill and street involved, and we’re very busy, and so I would have called you earlier, but I was busy helping a sad man do his laundry, and feeding the hungry, and then breaking up a would-be fight.

When I got a hold of you, you gave me your address. And I said I would try to stop by that evening, when you planned on being home. And then you said, ‘before you come by, phone me,’ and I said ‘sure!’ because, sir, well, I’m stupid. And then I hung up, and swore, and thought of calling you back, but was far too embarrassed to do so.

And I really did plan on stopping by that evening, but I volunteer with this little girl with Big Sisters every week. And so I went to see her straight after work, and we went bike riding, and it took longer than I thought it would because her legs were small and she’s just learning. And after I dropped her off at home it was already 9:30 at night, and I thought you might be sleeping, and so I didn’t drop by to get my phone. And I would have called but…you know.

And then today I took my puppies and walked by your house, which was really far away, and I don’t have a car, but we found it and I knocked on your door. But you weren’t home. And I was sad.

You see, I lost my cell phone the evening before my birthday. And I don’t generally like birthdays, but my family does, and they like to call to harass me and feel happy. And they couldn’t, because I don’t have my phone. And a couple of friends tried to call, but they couldn’t leave a message, because my mailbox was full. And then the only person who got to wish me happy birthday was one client at work…but he technically wished me happy birthday the day before, and earlier today, too, and I think he might just say that to everyone every day. And I’m feeling especially lonely because my little sister was staying with me for three weeks, but she left on Monday, and so my house feels really quiet, and I’d love to talk to her, or anyone, but…You have my phone. And now I’m sad.

So if you could please email me, and let me know when you’ll next be home, so that maybe I can walk the twenty blocks back to your house to get my phone, that would be very nice of you. Thank you.


Wednesday, August 26, 2009

A Post Traumatic Life

Could it be that every mental disease that ever was can be summed up as a colourful form of Post Traumatic Stress Disorder?

Well…let me be clear. PTSD is a specific illness, and those brave souls and pharmaceutical executives currently putting together the DSM-V would be rolling in their king-sized beds if they heard any such nonsense. Certainly, I’m oversimplifying. But perhaps you all should, too.


Post traumatic stress disorder is an anxiety disorder common in veterans and characterized by flash-backs, vigilance, and general unhappiness following a period of intense and potentially life-threatening trauma. Because of our love of sending soldiers out to watch their brethren die, we’ve had a long history of studying their trauma, and its cost to our military efforts. Thus we’ve coined terms like Combat Stress Reaction, Battle Fatigue, Soldier’s Heart, Shell-Shock Syndrome, and Neurasthenia.

For those who’ve been in The Shit, or experienced its many renditions (now helpfully rendered on DVD and VHS) then this shouldn’t be very surprising. Killing people and watching others be killed is the sort of thing that’s supposed to give you a psychiatric disorder if anything will. Being engulfed in a chaotic atmosphere of fear and constant vigilance, occasionally killing civilians and friends, usually by accident, and seeing a slaughtered baby, once and a while, for months or years at a time, is the sort of thing that will fuck up the best of us and then some.

Armies and governments began to understand the implications of this after the Vietnam-American War (although that understanding is still, today, a very limited one). Before PTSD and the age of pop-psychology, words like ‘psychological distress,’ ‘social withdrawal,’ and ‘acute alcoholism’ simply didn’t exist. Instead, we called those things ‘being manly.’

Today, with our ever-growing social demands and access to Wikipedia, such behaviours are increasingly seen as disorders, and those disorders are given out names. A great many soldiers qualify for a diagnosis of PTSD, but many others will, now and years later, qualify for a range of different diagnoses. Many will drink, and smoke, and intravenously inject their troubles away. Some will hallucinate. Others will have nightmares or insomnia. Others will exhibit mania, and others depression, and still others a range of physical symptoms from headaches to impotence which will never be fully explained.

In other words, soldiers may exhibit a full range of symptoms which could qualify as any number of difference disorders, all of which are post traumatic, and therein lies my point. (And it’s a good one, even though most of us are not, and never will be, returning combat soldiers.)


Every psychological and psychiatric expert will agree that this much is true: everyone has genes, and everyone has stress. This is where the agreement stops, and experts struggle to comprehend how much of our brains (and our brain diseases) stem from our DNA, our development, or the environment we experience in our day-to-day, adult lives. While we’ve pegged specific chromosomes in neurological or developmental disorders like Down’s Syndrome, but mental illnesses seem infinitely more complicated.

Take schizophrenia, which no one really understands and many believe is made up of a number of different disorders. Formerly, schizophrenia was simply ‘neurosis,’ and before ‘neurosis’ was ‘demon possession’ and good, old fashioned ‘witchcraft’…which really could have been nothing more than neighbourly discord, or a vitamin deficiency, which has been known to cause hallucinations and bizarre behaviour, too.

Today, what we know as schizophrenia certainly has a large genetic component. But when one identical twin gets schizophrenia, his genetically-identical sibling falls ill only 50% of the time. Their shared DNA predicts a very large chance of getting schizophrenia, but not the illness itself. To get the hallucinations, thought disorder, and/or catatonia, environmental components are needed, which are infinitely more complex than even the Human Genome Project.

Most psychologists accept that there is a marriage between nature and nurture which together explains our personality, thought, and behaviour, and the disorders plaguing one or all three. A person’s DNA predicts their development and their brain, but lots of other things interfere and act along the way, and in the end we get our love of cheesecake, our fondness of the colour blue, and our belief that we are being spoken to by Jesus Christ’s reincarnation, the Cheese King, through the microphones placed in discarded nickels, and so on. Experiences act upon our brain, and our brain dictates how we interpret and respond to each experience.

The most accepted model for psychiatric disorders is one of diathesis-stress. A person’s brain, constructed by their genetic code, is a diathesis on which a stressor acts, best explained by way of metaphor.

DNA acts as a blueprint, and in the end we get a brain, or a house. And houses, you may notice, entail a great many parts…windows, doors, rooms, shingles, plumbing. And then, outside of the brain, and the house, you have an environment, and environmental stress. We call this ‘life.’ And life is sometimes a bit like a hurricane.

But when houses begin to fall apart, they do so in a variety of different ways. Some get flooded basements, and some get short-circuited electricity. Some lose their shingles, and still others lose doors or window panes. And the blueprints of your house may not predict the nature of the damage when disaster strikes, but it may provide some clues. Your house may have large picture windows which easily break, or be made of a wood that tends to rot and be eaten by mould. Perhaps it comes from a line of houses, all made by the same manufacturer, none of which have reliable hot water. And when a hurricane knocks down another house entirely, yours may be left with only a few torn-off shingles.

Such is the nature of houses and hurricanes. Soldiers returning home from a combat zone return to houses with chronically flooded basements, and even the most resilient of minds have spotty electricity during powerful storms.

Because of our widespread study of soldiers and their experiences, we’ve declared their anxiety to be post traumatic. But life, it seems, is full of trauma, and for those who experience anxiety, depression, or even hallucinations, they just might be post-traumatic, too.

Take hallucinations, which we tend to associate with schizophrenia, but which occur in perfectly non-schizophrenic people, too. Ten to fifteen percent of the general public have reported experiencing auditory hallucinations, and many have noted that the differences in perception between schizophrenics and the rest of us tend to be far less than previously thought. For example, 10% of studied individuals have heard their own thoughts spoken aloud, and many have had hallucinatory experiences related to the death of a loved one. While psychiatry views all these instances as psychotic, proponents of the dimensional model of psychosis would argue that they fall within the normal realm of experience.

The majority of individuals who routinely experience hearing voices have noted that they appeared after a traumatic, triggering event, and that how people react to these voices, and not the voices themselves, determine whether or not a person is able to function and thrive. A reaction of anxiety and fear leads into paranoia, while a culturally accepted hallucination (the voice of God heard by a stoic Christian) may lead to praise and acceptance.

Other psychiatrists have noted that an experience of trauma, and especially trauma in childhood, can lead to a full spectrum of psychiatric symptoms which could meet the criteria for almost any single disorder. And this, too, is an intuitive fact; we’ve known for years that any individual, when tortured enough, isolated enough, and subjected to enough abject cruelty will break (though the manner in which they do so may vary widely). And when moderate childhood trauma meets everyday adult trauma (e.g. running over a man with your sky train, or discovering your grocery store has run out of Diet Coke), psychosis and psychiatry ensues.

And if you don’t believe me, it might be worth noting that Railway Spine was a specific, observed disorder affecting those who’ve experienced a train wreck in 19th century Europe, causing anxiety, depression, impotence, and disturbances of appetite. The cause was thought to be exhaustion of the nerves due to the crash’s physical trauma on the brain and spine.