Scathing-obituary-goes-viral-describes-abusive-violent-motherI read the obituary of Marianne Theresa Johnson-Reddick with interest.

She tortured people by her cruelty.

This abusive mother did not get a free pass to the afterlife. Two of her eight children let the world know how they were all “abrasively exposed to her evil and violent life” in her obituary.

“Mom” ran a prostitution ring, or “escort service” as the woeful women who turn tricks and the desperate men who pay for them prefer to call it.

“Everyone she met, adult or child, was tortured by her cruelty and exposure to violence, criminal activity, vulgarity and hatred of the gentle or kind human spirit,” the obituary said. “Our greatest wish now is to stimulate a national movement that mandates a purposeful and dedicated war against child abuse in the United States of America.”

It’s unfortunate that eight children had to suffer for so long, but I applaud the desire of the two who wrote her obituary to use their mother’s death as a call to shine a light on child abuse. (Learn more about what you can do to prevent child abuse.)

Perhaps that discussion will include the following valuable tidbit: Family planning is an excellent strategy for men and women who don’t want to be parents to remain childless.

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On the shelf of my cubicle sits a Hallmark-brand Peanuts tree ornament with Charlie Brown seeking Lucy’s 5-cent psychiatric help. It reminds me of watching every holiday Peanuts TV special while growing up and the mental health setting where I work today.

Hallmark moments create a warm feeling, don’t they? A kind of Hallmark moment came to mind recently as I read about the nation’s first electronic mental health screening kiosk. The gizmo is stationed in a wellness clinic at a Philadelphia ShopRite grocery store.

Finally! The blood pressure cuff station at the grocery store has a companion, one that will encourage people to stop and take stock of how they are feeling today, á la Charlie sitting down with Lucy.

Here’s How it Works

A Charlie or Charlotte Brown steps up to a touch screen and answers just over a dozen questions for a quick checkup from the neck up. Now that’s what I call normalizing mental health, courtesy of today’s technology and research-proven questions.

The kiosk pictured here sits in the wellness clinic’s waiting area for tests for strep throat, vaccinations, etc. I only hope that this single kiosk’s results will create a snowball effect, ending with private and commercial support to put one of these kiosks in every in-store medical clinic in the country.

kiosk

What Does this Screening Do?

Developed by mental health professionals, the questions cover seven areas to identify signs and symptoms of common mental health issues such as anxiety, depression, trauma issues, eating disorders, substance misuse and bipolar disorder.

Charlie or Charlotte Brown walks away with a printout that states whether there is a reason to be concerned. If further assessment is recommended, referrals to nearby mental health services lands in Brown’s email inbox. Not intended to provide a diagnosis – that’s up to a professional – it is a positive starting point, isn’t it?

While the kiosk doesn’t include human interaction, it may be just the thing today’s smartphone-app-happy society will accept. The kiosk doesn’t require someone to search for a suitable app. It’s right where you’re passing with your grocery cart. Consider that Americans made 1.6 visits weekly to a grocery store in 2013 but they saw a doctor an average of just 3 times in an entire year. One in four Americans has a mental health issue every year, and just a quarter of those go get help.

When it’s time for help, then it’s time for the human intervention. When that happens, treatment is effective for nearly 90 percent of people.

Online screening tools have the potential to motivate people to get help earlier and suffer less. That would be a Hallmark moment in a lot of homes and lives.

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Thirty years ago, I submitted a manuscript for publication and received the following response from the editor: “There is nothing new here, but some ideas warrant repeating.” The manuscript was published.

I have already written about the problems in reframing psychiatric disorders as brain disorders, but I was inspired to write yet another post about depression more specifically when I read a passage that resonated with me—especially intriguing because it was not penned by a mental health professional but rather by a philosopher, Alva Noe, who also has acquired expertise in cognitive science and neuroscience.

In the preface to his book, Out of Our Heads: Why You Are Not Your Brain and Other Lessons from the Biology of Consciousness, he wrote the following about the idea that depression is a brain disease:

“In one sense, that is obviously true. There are neural signatures of depression. Direct action on the brain—in the form of drug therapy—can influence depression. But in another sense, it is obviously not true. It is simply impossible to understand why people get depressed—or why this individual here and now is depressed—in neural terms alone. Depression happens to living people with real life histories facing real life events, and it happens not only against the background of these individual histories but also against the background of the phylogenetic history of the species. The dogma that depression is a brain disease serves the interest of drug companies, no doubt; it also serves to destigmatize the struggle with depression, which is a good thing. But it is false.”Brain

I think Noe has the perspective just right and expressed it eloquently. Unfortunately, as I’ve written in previous posts, he was wrong about one thing: construing psychiatric disorders as brain disorders has not ameliorated stigma.

The only solid rationale for the brain-disorders view is the plain truth in it, as Noe states. But this truth can obscure another truth that Noe has firmly in mind: in conjunction with genetic risk, disordered brains develop from disordered lives.

As my colleague, Tom Ellis, PsyD, ABPP, pointed out when he read this line, we should keep in mind that this adverse influence goes both ways; in his words, Disordered lives damage brains no less than disordered brains damage lives.” The disorders in lives relate extensively to problematic relationships throughout the lifespan. Traumatic experiences in attachment relationships, earlier or later in life, are a particularly significant risk factor for depression. More broadly, I think of a pile-up of stress over the course of the lifetime as the major contributor to disordered brain functioning in depression, as it is in many other psychiatric disorders.

Simply put, the danger in the brain-disorders view of depression is that patients will focus solely on medical treatment (primarily, medication) and will not adequately address the stressful life experiences and relationships that play such a significant role in depression. The worst-case scenario is patients feeling hopeless because they are told they suffer from “treatment-resistant” depression owing merely to poor response to medication.

I feel fortunate to work in a hospital where treatment-resistant depression is addressed not only by refining the medication regimen but also through extensive education coupled with individual and group therapy along with family work—all in a therapeutic milieu that supports engagement in healing relationships with staff members and peers. Similarly, in outpatient settings, treatment with medication is optimally coupled with psychotherapy; marital and family therapy is always something to consider as well.

We need to attend to the health of the brain, but never to the neglect of the life of the person—who, as Noe emphatically states in his book, should never be reduced to a brain.

References:

Allen, J.G. (2006). Coping with depression: From catch-22 to hope. Washington, DC: American Psychiatric Publishing.

Noe, A. (2009). Out of our heads: Why you are not your brain, and other lessons from the biology of consciousness. New York: Farrar, Straus and Giroux.

 

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Of course I’m envious!

by Herman Adler, MA October 17, 2014

A few years ago I wrote a blog post about the trait of stubbornness and its application to personality disorders. This time, I’m here to delve into the complicated and misjudged trait of envy. According to the DSM-V, the trait “often envious of others” is among the traits of narcissistic personality disorder. Two perfectly reasonable […]

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Tackling the Problem of Domestic Violence

by Dallas Adams, LCSW October 10, 2014

Why write about domestic abuse and violence in a mental health blog? Especially since these two behaviors are not caused by mental illness? I write about domestic violence and abuse here because domestic violence and abuse can result in physical injury, psychological trauma and, in severe cases, even death. The devastating consequences of domestic violence […]

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Quiet: A Book for Introverts

by Jon G. Allen, PhD October 3, 2014

Being a prototypical introvert, I was drawn to Susan Cain’s popular book, Quiet: The power of introverts in a world that can’t stop talking. Cain’s subtitle could have been shorter: “In praise of introversion.” Sadly, her subtitle also could have been: “In defense of introversion.” The basic premise of her book: About a century ago, […]

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Is anomie the enemy? Another perspective on the increase of school shootings

by Hannah Szlyk, LMSW September 30, 2014

Anomie: the breakdown in the bond between the individual and community is evidenced when there is a discrepancy between the values and ideologies of society and what is achievable in normal life. This term, popularized by French sociologist Emile Durkheim in his 19th century book Suicide, was referenced in a discussion of the recent school […]

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We Are Becoming Less Violent

by Jon G. Allen, PhD September 25, 2014

Perhaps I can be forgiven for my pessimism about ameliorating the violent side of human nature. Like everyone else, I am assaulted on a daily basis by stories of violence, including war, genocide, terrorism, homicide, rape and child abuse. Compounding this routine assault, I have specialized in psychological trauma, which entails professional immersion in suffering […]

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Robin Williams and the Power of Suicide

by John Oldham, MD, MS August 13, 2014

For the last several days, we have been riveted by the tragic suicide of Robin Williams, a larger-than-life favorite on both the large and small screens. However much we know about the prevalence of depression and of suicide itself, we are still shocked when someone who feels so familiar chooses this way to disappear. Yes, […]

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Attempting suicide (and living to tell the story)

by Thomas Ellis, PsyD, ABPP June 2, 2014

I have been attending professional conferences for more than 30 years, so they have become rather predictable to me. Plenary sessions, research paper presentations, skills workshops: Sessions are generally informative, though sometimes deadly dull. That said, my experience at the 2014 conference of the American Association of Suicidology in Los Angeles a few weeks ago […]

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