Psyched Out

Expect this Journal entry to be somewhat disorganized and random. I'm having all kinds of different responses to the experience of application, admission, financial aid and now at last the first week of class. This is my first class in 11 years, and I'm overjoyed to be in grad school. After being the first person in the history of my extended family privileged to attend college and earn a Bachelor's degree, I'm aiming to be the first of many generations to come to have a Master's degree as well.

I earned my psychology BS at a competitive and very serious program in a huge research oriented public university. I can count on one hand the number of times I heard a joke in class and more than slightly smiled. Spending an hour and a half in class belly laughing nonstop is quite a contrast. I love it though, and it confirms that GVSU is the perfect school for me. Of all the imaginings of what grad school would be like, I never envisioned gasping-for-breath laughing playing a part!

I have worked pretty hard at cultural competency in my social work practice as well as life in general. I recognize that my life as a middle class white woman is extremely privileged in most ways. Most of the white people I encounter either don't recognize or completely reject white privilege. I don't have to dress up to be accepted as a peer by most people. I don't get speeding tickets if I drive through the "wrong" town/part of town at 1mph (or 0 mph) over the speed limit. I can travel to rural Michigan areas without fear. Recently a work friend moved to Caledonia, and an African American work friend said sadly that she won't be able to go to the new house, because it might not be safe for her.

I live in a white flight neighborhood and cherish the diversity my twins are growing up with. I grew up in an all white school district in Iowa. My twins' schoolmates are of every race, and it definitely helps them naturally learn that all people deserve respect and civil rights.

Last summer I went to a "neighborhood meeting" of all white renters and (mostly) landlords airing their mostly racist grievances, except one AA woman. She attended and pointed out the total lack of police service her small son received when a teenager pushed him off his bike in front of an officer in a SQUAD CAR 10 feet away who didn't help the child. Nobody but me seemed to believe that her six year old really encountered any discrimination. After several people complained fearfully about "gang activity" I had to explain that 5 black boys laughing in a front yard is NOT a gang, any more than 5 white boys. The police at least backed me up on that one. I have a good deal more in common with my mostly African American neighbors than with most local middle class white people. I share the working class background, the experience of being poorer than most of my classmates growing up, and many of the same non-CRC values such as expressing emotions openly.

When we needed to find a daycare provider fast while the kids were 3, the white sitters in our area were all kind of anal retentive. One said that she made the (preschooler) kids walk at least three miles a day regardless of the weather. Another told us that our twins must have been lying to us when they reported that their immediately-fired babysitter spanked Teddy on the bare bottom for a peeing accident on the carpet, and that J--- "broke my penis." She said, "Oh, kids will make those things up to get out a situation." One even criticized our barely potty trained son because "You should stand up to pee, like other boys. Boys don't sit down like girls." Hello, sexism! Love that implication that being like a girl is a bad thing. Brenda, our African American daycare provider since then, is a degreed early education teacher who worked Head Start programs for over ten years before having her youngest child. We're really lucky she decided to stay at home with Dontrell, because Katie and Teddy have really benefited from her care and education. They were more than prepared to start kindergarten.

I still have a lot of areas to work on, though. I know very few people of Asian descent or immigration. I'm vaguely aware of very different family structures than are typical in other Michigan families. I know not to lump all Latinos together, but I don't know much about different Latino populations. I despise corporate welfare thriving while most of my clients can't afford medication or safe housing with their disability income.I am prejudiced against rich people, and aware that I need to work on this. One example and I'll stop writing! This is from a recent post I wrote on my blog:


Privelege Overflowing Like A Shit Filled Toilet


I work with a new client who has gone from making six figures and having three jaguars to being on disability ($1300/mo). He comes from an EXTREMELY wealthy family in the richest suburb in my state. His siblings are emotionally supportive and one of his brothers is his payee, but they don't help him financially at all despite stunning personal wealth. Someone in the hospital told him and his sister that my agency would pay for all his medication, which is a blatant falsehood. Now he and his family are FURIOUS. They refuse to believe that medical providers are not liable for providing him free medication. The sister's husband is a malpractice attorney, and they keep threatening to sue. I'm silently thinking, "Knock yourselves out. Nobody has a responsibility to pay for his medication except him. I personally hate that, but that's the way it is until we have universal health care."

I explained that I don't like it when homeless and indigent people can't get the medicine they need and live in fear and anxiety and depression and psychosis. I don't like it when it happens to formerly wealthy people either. I used my standard social work line, "All the people I work with are equally important to me." This works for both people who have self esteem trouble or depression (meaning "You are just as important") and with extremely entitled or narcissistic people (meaning "You are not more important").

So I spent an hour and a half of my life that I'll never get back saying "no" to people who would not accept that because basically nobody has ever said no to them before in their whole lives. Among the things said to me (followed by my internal reaction in ALL CAPS just to demonstrate how I was screaming replies in my head while apparently patient and calm.)

"This is just reverse discrimination."

UM, HELLO, THERE IS NO SUCH THING AS REVERSE DISCRIMINATION.

""If he were a black woman he'd get his medication from you for free." I did raise my voice a little saying, "Absolutely not!"

ABSOLUTELY NOT. AT LEAST A THIRD OF MY PATIENTS GO WITHOUT DESPERATELY NEEDED MEDICATION BECAUSE THEY ARE POOR BUT DON'T QUALIFY FOR MEDICAID OR MEDICARE. RACE AND GENDER ARE NOT RELEVANT IN THAT AREA. NOBODY GETS SPECIAL TREATMENT OR SPECIAL SERVICE FROM ME, INCLUDING YOU. SORRY IF HEARING NO AND COPING WITH IT IS NOT A SKILL YOUR PARENTS TAUGHT YOU. IT'S OFTEN HARDER TO LEARN IN ADULTHOOD.

"I didn't think we had welfare anymore."

YEP, THAT WOULD BE THE EXACT PROBLEM YOUR BROTHER IS HAVING AS WE SPEAK.

AND YOU'RE THE FUCKERS WHO VOTED TO DISMANTLE OUR SOCIAL SAFETY NET. YOU'RE ALSO THE ONES WHO VOTED IN AND INVESTED IN FOR PROFIT HEALTH CARE AND INSURANCE. AND THEN VOTED RESTRICTIONS FOR PERSONAL BANKRUPTCY WHEN THOSE FOR PROFIT MEDICAL BILLS MORE THAN DOUBLED IN COST, MAKING THE MAJORITY OF FILERS DECLARE BANKRUPTCY BECAUSE OF MEDICAL BILLS.

"[Psych hospital] and Community Mental Health and you are liable if you don't give him free medications and he gets sick again. You are responsible for guaranteeing his well-being."

HE IS RESPONSIBLE FOR HIS OWN WELL-BEING. BLOOD KIN, WHEN THEY EXIST, GENERALLY STEP UP TO THE PLATE AND HELP THEIR DISABLED LOVED ONES. IF YOU WON'T, NOBODY ELSE CAN. DID I MENTION THAT YOU'RE THE FUCKERS WHO MADE DAMN SURE OF IT? BY DESTROYING THE ALREADY MEAGER SOCIAL SAFETY NET. REAGAN, BUSH, W AND YOU ARE TOTALLY RESPONSIBLE FOR THIS SITUATION.


Okay, venting over! Time to go to bed. :)

Mental Illness and Murder

Contrary to popular belief, homicide due to mental illness is declining, at least in England and Wales:

The rate of total homicide and the rate of homicide due to mental disorder rose steadily until the mid-1970s. From then there was a reversal in the rate of homicides attributed to mental disorder, which declined to historically low levels, while other homicides continued to rise.


I have no doubt that in England and Wales, where there is universal health care and mentally ill individuals are able to take their medication because it is affordable or free, homicides committed by MI people have declined.

I've been a psychiatric social worker for 15 years, and I can tell you EXACTLY why other industrialized countries have lower rates of murder by severely mentally ill people - universal healthcare with parity between "physical" and "mental" illnesses. (Since all "mental" illness is actually physical, there should be no distinction made.)

Even US statistics show that mentally ill people are LESS violent than the general population when treated with medication. But effective antipsychotics tend to cost $800-2000 per month. Even the "wealthiest" people on SSI Or SSDI (disability) have entire incomes under $1200/month. Those $1200/month folks made six figures when working, BTW. The typical disabled MI person gets $200-500/ month for rent, food, medicine, utilities, transportation, and physical care necessities such as soap and shampoo and toilet paper. Even the lowest income medicaid recipient usually has a a monthly "spend down" (like a deductible) often EXCEEDING their actual monthly income. Living expenses are not considered when figuring spend down either. And medicare folks don't fare much better, their medicine is paid for (with a copay) for several months, then they hit a "donut hole" where medicare doesn't pay another cent until they have spent $2000-10,000 of their own income on the medication before medicare kicks back in. Again, living expenses are not considered and the demanded contribution often exceeds the person's actual income. You do the math.

Most mentally ill people, especially those who have hurt others when off medications, desperately want treatment. Virtually every murder by a mentally ill person is caused by all of us neglecting them and refusing them necessary healthcare. We can court order violent people for mandatory treatment all we want, but if they can't afford the medicine they aren't GETTING effective treatment. Even the most violently criminally insane person effectively has NO access to the treatment that would control their symptoms and prevent tragedies. Until we change that, innocents will suffer and die. And we will all be culpable.

I work with a new client who has gone from making six figures and having three jaguars to being on disability ($800/mo). He comes from an EXTREMELY wealthy family in the richest suburb in my state. His siblings are emotionally supportive and one of his brothers is his payee, but they don't help him financially at all despite stunning personal wealth. Someone in the hospital told him and his sister that my agency would pay for all his medication, which is a blatant falsehood. Now he and his family are FURIOUS. They refuse to believe that medical providers are not liable for providing him free medication. The sister's husband is a malpractice attorney, and they keep threatening to sue. I'm like, Knock yourselves out. Nobody has a responsibility to pay for his medication except him.

I explained that I don't like it when homeless and indigent people can't get the medicine they need and live in fear and anxiety and depression and psychosis. I don't like it when it happens to formerly wealthy people either. I used my standard social line, "All the people I work with are equally important to me." This works for both people who have self esteem trouble or depression (meaning "You are just as important") and with extremely entitled or narcissistic people (meaning "You are not more important").

So I spent an hour and a half of my life that I'll never get back saying "no" to people who would not accept that because basically nobody has ever said no to them before. Among the things said to me (followed by my internal reaction in ALL CAPS just to demonstrate how I was screaming replies in my head while apparently patient and calm.)

"This is just reverse discrimination."

UM, HELLO, THERE IS NO SUCH THING AS REVERSE DISCRIMINATION. THERE IS MUTUAL RACISM, BUT THAT'S NOT DISCRIMINATION.

""If he were a black woman he'd get his medication from you for free." I did raise my voice a little saying, "Absolutely not!"

ABSOLUTELY NOT. AT LEAST A THIRD OF MY PATIENTS GO WITHOUT DESPERATELY NEEDED MEDICATION BECAUSE THEY ARE POOR BUT DON'T QUALIFY FOR MEDICAID OR MEDICARE. RACE AND GENDER ARE NOT RELEVANT. NOBODY GETS SPECIAL TREATMENT, INCLUDING YOU. SORRY IF HEARING NO AND COPING WITH IT IS NOT A SKILL YOUR PARENTS TAUGHT YOU. IT'S OFTEN HARDER TO LEARN IN ADULTHOOD.

"I didn't think we had welfare anymore."

YEP, THAT WOULD BE THE EXACT PROBLEM YOUR BROTHER IS HAVING AS WE SPEAK.

AND YOU'RE THE FUCKERS WHO VOTED TO DISMANTLE OUR SOCIAL SAFETY NET. AND YOU'RE ALSO THE ONES WHO VOTED IN AND INVESTED IN FOR PROFIT HEALTH CARE AND INSURANCE. AND THEN VOTED RESTRICTIONS FOR PERSONAL BANKRUPTCY WHEN THOSE FOR PROFIT MEDICAL BILLS DOUBLED IN COST, MAKING THE MAJORITY OF FILERS DECLARING IT BECAUSE OF MEDICAL BILLS.

"[Psyh hospital] and Community Mental Health and you are liable if you don't give him free medications and he gets sick again. You are responsible for guaranteeing his well-being."

HE IS RESPONSIBLE FOR HIS OWN WELL-BEING. BLOOD KIN, WHEN THEY EXIST, GENERALLY STEP UP TO THE PLATE AND HELP THEIR DISABLED LOVED ONES. IF YOU WON'T, NOBODY ELSE CAN. DID I MENTION THAT YOU'RE THE FUCKERS WHO MADE DAMN SURE OF IT? BY DESTROYING THE ALREADY MEAGER SOCIAL SAFETY NET. REAGAN, BUSH, W AND YOU ARE TOTALLY RESPONSIBLE FOR THIS SITUATION.

Okay, venting over.

8/9/74 - *

I was six and had my tonsils removed in a vain hope that it would help my asthma. I was still pretty groggy from the anasthesia, so a nurse was holding a cherry popsicle while I eagerly swallowed to numb the pain.

My parents and the nurse where all captivated by the TV. The nurse pushed the popsicle a little to far and VOILA!

I threw up during Nixon's resignation speech.

My Democratic, union member parents were thrilled. So was the nurse, and pretty much everyone on the peds unit, all union. People kept on sticking their heads in the room and saying, "You know, I wanted to throw up too!" I was a hospital superstar!

So I've lost 31 pounds unintentionally after starting a medication that typically causes weight gain. Not so for me. Some of you are likely aware of the effect SSRIs for depression have on libido. Eradicate it. It's possible to have sex. It can feel nice when it happens. But there's not a shred of desire most of the time. Something that was a delight before, that you wanted and looked forward to and initiated at half a chance just isn't interesting anymore. There's no desire.

That's what happened to my totally moderate and intuition driven appetite for food. It's just gone - disappeared entirely. I am mildly hungry when I wake up. I get my cini minis and coke "breakfast of champions" and then I just don't get hungry. Around ten at night I get mildly hungry. I eat a frozen entree and go to bed. My shorts are literally falling off. I had to exchange them once for a smaller size, and a couple of weeks later THOSE are literally falling off. I can't exchange those, I've worn them. I had to buy safety pins (which incidentally they don't even pretend is a baby item anymore, it's shelved in the miscellaneous aisle)to pin them on my body.

Naturally the weight is all coming off my hips, proportionately small, instead of the SHELF OF FAT above my belly button. It's like the biggest muffin top ever. And it has never gone away. When I couldn't afford food other than rice for a year and got bronchitis and pneumonia and couldn't afford my asthma medicine and walked five miles each way to work and weighed 140? Still there. Nice big twin pregnancy belly? No cute preggo belly for me - still there. I completely accept my body and love a good many parts of it. Including an eraser sized mole on my left forearm, which sort of tells me that I'm ME - it's a little spot of uniqueness. Medical staff have offered to remove it because they could technically get away with a melanoma "biopsy" due to the size. I've always said no thanks.

Now, I'm nowhere near losing my supersize cred. I still weigh 275. I don't imagine that loss of appetite is going to take me out of my set point range. I have bunches of coworkers counting points and having a biggest loser type contest. And I think I've lost more weight than any of them. I just don't talk about it to them. Kind of like I can't join in the women's social ritual complaining about husbands. "Wow, my husband would never do that! You married an asshole." is not in the script. :)

I admit that I'm enjoying it. I can feel the difference in my dance-induced osteo-arthritic knee. I can fit into a pair of bright beach print capris I love again. If I lose another ten pounds I'll probably be able to shop for pants at Target. My shirt size is never going down due to my nice strong linebacker shoulders. I've never been the kind of fat activist who would pass up a legitimate and low side affect treatment. You know, one that doesn't cause weight gain like dieting does. Being fat is part of my identity, but if it were treatable I would happily take a pill, just like I take one for depression, which many consider "character building." Uh, yah, fuck that.

I don't see one coming down the pike in the next hundred years anyway. Phenotypes are had to medically hack. Look at Michael Jackson. Besides which, I am no more likely to be less at risk of high blood pressure because I'm a socially acceptable weight, than Michael J is as an African American, regardless of how much he has lightened his skin and changed his nose. Because cosmetic changes do not trump genotype. Attempts to increase and decrease height have mostly been failures, and when they work the side effects are usually grave problems themselves. Weight is as heritable as height, and runs in biological but not adoptive families. It's not about food intake, it's about the natural and healthy variation in body size. People can look at Danny DeVito and Kareem Abdul Jabar and accept that HUGE healthy variation. Tall people have more strokes. Short people die when airbags deploy and smother them. Life only ends in one way - death. And it is too short to obsess about appearance when there are people to love and good work to do and fun to be enjoyed.