The Necropolitan Sentinel

In the past couple of days, Stacy's been writing (here, here, and here) about the important topic of how the ever-broadening categorics of mental illness undermine the concept of individual agency on which civil societies are built, and how malignant narcissists find in the therapeutic gobbledygook a bevy of excuses for their 'alternately enabled' behavior. The incident that inspired Stacy's writings is the Sandy Hook massacre, and more particularly the legacy media reaction to the atrocity.

I agree that the proliferation of categories of mental illness is a boon to the 'therapeutic community,' and that much of it is a racket. The federal government's attack on the profession of medicine, in which apparatchiks and bean counters are given the power to determine what will or will not be paid for exempts a variety of pseudo-scientific quacks from the stringent standards that are placed on well-trained doctors and nurses, and their liability exposure is one of the ways Big Government intends to drive them into the ranks of government employees. Some of the dangerous legislative and bureaucratic lunatics to whom Stacy alludes even want to see medical professionals unionized, because everyone knows that unionized government employees always strive to do the utmost that they can, because those unions exist to make sure that they are held to the highest standards of accountability, which is why the UK's National Health Service is so deeply humane and scandal free. New Age quacks, on the other hand, receive pay-outs from Medicare without any regard to the efficacy of their treatments, and they can't really be held accountable because . . . caveat emptor applies to 'faith-based' medicine. Which is "differently enabled" medicine, and screw that Enlightenment crap.

For example, if a person is re-admitted to a hospital within 45 days of discharge, whether or not the re-admission is due to a condition medically unrelated to the one for which that person was treated in the hospital, or the result, say, of a slip and fall or even an auto accident, the hospital will be fined by the government, because having been admitted to the hospital that person now has the sort of implied health warranty a certified used vehicle sold by Toyota ought to have. However, you will not find alcohol and drug rehab programs subject to the same ridiculous conditions. If a person leaves one of those programs and relapses within 45 days, which is a common occurrence, no fine will be imposed, nor should  it be. Whether specific programs at specific locations actually realize a basic level of success in outcomes, though, Big Government seems to have little interest in determining under a reasonably stringent methodology. Obama can lie about his mother's treatment by those horrible health insurers, when in fact her claims were paid in full, and liberals can declare that no person or family should have to lose their life savings in desperate medical straits, but in fact private rehab facilities build Taj Mahal physical plants on the dimes of desperate parents who will mortgage everything to get their meth-addled children out of the sewer.

And you know, it's those conservatives who are anti-science.

Where I do depart from Stacy is where he chooses to go off on Liza Long's account of her 13-year-old son, suggesting that if Liza and people like her used more discipline, things wouldn't have gotten so out of hand in the first place. And the reason that I disagree with Stacy's assessment is that I have been in the place Liza Long finds herself, with regard to my then 9-year-old son, Aidan. I've recounted that nightmare before. There were times when I put him in an arm-bar or a headlock in order to prevent his violence. But when you have a child who is alternately sobbing that he's a ghost, and that you've killed him, physically attacking his parents and siblings over imagined insults, and smearing feces on his bedroom wall, you have seriously to conclude that he is in the grips of serious psychosis.

That's a very shorthand way of stating what I and my family, Aidan not the least, went through. For over half a year, Aidan was institutionalized at the Brattleboro Retreat, a two and a half hour drive from where we lived. Mary and I alternated driving there just about every day, that entire snowy winter, while they attempted to find medication that would control his psychosis, leaving after work and arriving home 6 hours later after a short visit during which he might or might not interact. Once, he asked Mary whether she was really his mom. He believed that his real parents had been replaced by facsimiles.

I can say that I meted out a lot of discipline, including long hikes at dawn in weather of all sorts, in an attempt to get him reconnected physically with his body and surroundings, since Aidan loved to be outdoors. His increasingly palimpsestic drawings chronicled his growing confusion. What had once been the ability to make connections among disparate phenomena was now hyperconnection. The intellect must synthesize, but it must also distinguish. It was all collapsing in a Babel.

Childhood Onset Schizophrenia is rare enough that Aidan's very accomplished attending physician hadn't ever seen it, so we decided the only way that we were going to get the solid diagnosis that we needed would be to take him to the NIMH. The method at the Brattleboro Retreat was to provisionally diagnose, prescribe on that basis, and find out what kind of results a particular medicine appertaining to a particular diagnosis would bring. Inexorably, we inched towards schizophrenia, and Aidan's response to clozapine, which is pretty much the gold standard in anti-psychotic medications, seemed to seal the deal. Once at NIMH, Aidan had to be stripped of his medication, allowed to relapse into delusion, and then be built back up a couple of times, so they could try their hunches at other meds that might reveal another diagnosis, but at the end of it all, Aidan was diagnosed as suffering from Childhood Onset Schizophrenia and placed on a drugs regimen that controlled both the psychosis and the side effects of the clozapine.

Aidan had read at or above grade level when he became ill. He had been a popular kid in his class, a constantly active risk taker, a good athlete. He was a particulary gifted artist, able to draw objects in perspective, animals in motion, crystals (with superhuman precision), plants, faces. All of that was gone. Schizophrenia spreads like a fire from one end of the brain to the other. MRI images showed that compared with his siblings, Aidan's brain had ceased to record the development of the folds in the cerebral cortex that would be typical of his age. He would have to re-learn how to read and how to write. Heartbreakingly, his memory told him that he was no longer the same person on whom those impressions were inscribed, and he, and we, had to accept this.

It was very hard.

Yet, compared to the experiences of other families whom we met at the NIMH, flying down there alternate weekends throughout Aidan's long initial stay, we felt fortunate to have arrived at our diagnosis as quickly as we did. Some had wandered in the wilderness for years. I have to say that these were all people who would not think of relinquishing the care of their child to an institution, though I know such parents do exist. The road to getting a diagnosis and an effective plan of treatment is so difficult, despite the efforts of organizations such as NAMI, which does wonderful work, that only the most motivated parents arrived at the NIMH . . . or at least that is my impression from the ones I met.

From my reading of Liza Long's description of her son's behavior, I have to think that he's a likely candidate for the same diagnosis.

We still don't know what's wrong with Michael. Autism spectrum, ADHD, Oppositional Defiant or Intermittent Explosive Disorder have all been tossed around at various meetings with probation officers and social workers and counselors and teachers and school administrators. He's been on a slew of antipsychotic and mood-altering pharmaceuticals, a Russian novel of behavioral plans. Nothing seems to work.

Yeah, that's called the bargaining stage of grief. Zyprexa, which is what Michael is being given, is an antipsychotic, but one which receives low marks for the treatment of Childhood Onset Schizophrenia at the NIMH. Two of the other families we encountered there with schizophrenic sons (COS strikes boys at a rate of somewhere in the vicinity of 5:1 to girls, I would bet) had tried that medication and found the results unsatisfactory. It also has weight gain as a side effect, causing one of them to label the drug Zyporka. In all of the cases of parents of COS kids whom I've gotten to know well, clozapine has been found to produce the best results.

Institutionalization is desirable, in some cases; at least in comparison with the alternatives. Stacy quotes Ann Althouse on the aftermath of the mental-illness rights movement in the Seventies and Eighties, that saw many homes for the mentally ill closed, with the 'differently enabled' cast out on the streets, where they could fully enjoy the freedoms of homelessness, abuse, victimization, incarceration, drug addiction and the rest. The Carter and Reagan administrations played along with the standard bearers for the rights of the insane. They have died on the streets, from drugs, cops, criminals, hypothermia, alcoholism. They have ended up in prison, exposed to the tender mercies of fellow inmates and guards. They have been enslaved and exploited. They have disappeared, sometimes with the aid of people in the Death with Dignity movement, who have helped to disappear them.

The expansion of newly minted varieties of mental illness categories doesn't help people with severe mental illnesses, whose symptoms can be conned at a glance from an MRI. I'm not an expert any more than Stacy is, but borderline personality disorder just isn't in the same league. The diagnostic charts make their distinctions, but politicians and the general public tend to view it all as a lump of arcana, and to flatten the distinctions. If one category deserves treatment, then why don't the others? Obviously, under such conditions there's increased competition for the limited resources that have to be divided to address the clamorers for more, and obviously I can easily stand accused of special pleading. But to repeat an observation regarding my son, the intellect must simultaneously synthesize and make distinctions. The liberal always places the emphasis on synthesis, which is why the liberal always has some form of moral equivalency on his lips, and which is why, also, Stacy rightly states that a diagnosis, and particularly a self-diagnosis, ought not give a jackass sociopath carte blanche to perform whatever (as Ace puts it) "I gotta be me" jackassery he whimsically and viciously decides to unload behind a shield of "I can't help it." The continual expansion of the idea of mental illness by the therapeutic community, headed towards encompassing the entirety of the human race, increasingly usurps the Christian concept of "original sin," with the distinction that the receiving of the host that bridges the gap between Divine Integrity and our grovelling sinfulness is displaced by the prescription of pharmaceuticals that can point us in the direction of some putative normalcy, as determined by a cadre of psychologists, many of whom are themselves highly neurotic by the terms of their own diagnostic methods, and who derive their power from state bureaucracies which have their own agendas and their own ideas of what constitutes normalcy.

There's nothing really new about this reconstitution of religion in the guise of the Almighty State. Christian teleology, which liberals like to deride (and in some cases, in my opinion, with good reason) was stolen and repurposed by Marxist inevitability, which Kruschev famously invoked as he banged his shoe on the podium, promising that the Soviet Union would bury the US. Instead, they substitute their own teleologies. When, in the wake of the Sandy Hook massacre, Obama goes on television to say that "we must change," he doesn't mean that he is part of that we. He means that you and I must change, because we are not as enlightened as Obama and his co-ideologues. He means that the idea of America must change, the idea of being American must change. Illegal aliens have the right to be Americans, but Americans mustn't think they should enjoy the liberties prescribed in the Constitution and Bill of Rights, which must also change.

It all comes down to the formula, "Life is hard; surrender your agency and we will make it easier." The formula, which Stacy reproduces, from Liza Long's piece, that her son is "subject to violent outbursts," certainly reflects that subjection, that idea of surrendered agency. The Christian, by contrast, assumes the via crucis in an attempt to become more Christ-like. It calls for sacrifice, responsibility, agency, introspection, honesty. Allah wants slaves? Translate that into subjection to liberal policies, and you have the fundamental idea of Obama's New America. Still, there are subjects to mental illness, who have had their agency evaporate to some degree. I know, because my son is one of them. For all I know at this point, the shooter was also one, but if that is the case the premise that people who suffer from serious mental illness are merely differently enabled, cognitively speaking, is certainly at least as much to blame for this atrocity as are guns. And Liza Long is not wrong to point that out.

In certain cases, when it suits their agendas, leftists will make distinctions. Therefore, it is kosher for Native Americans to take peyote as part of their religious ceremonies (which doesn't bother me), but Catholic and other Christian agencies and institutions mustn't try to exempt themselves from having to pay for abortion insurance. On the other hand, the lion's share of the exemptions from ObamaCare must go to the unions that pushed so hard to get it, and . . . card check.

Some of you kind people will ask how Aidan's doing, and I will say that he's leading as normal a life as he possibly can, and that he's an eminently lovable person, and that he's generally happy, though sometimes a bit lonely, and that his family is very grateful, God bless and keep him. We are particularly grateful that he doesn't have to be institutionalized, though I pray that when we are gone he is protected.

UPDATE: Thanks very much to Stacy for the link.

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