Tuesday, January 18, 2011

When should people be made to "seek help"? It's a dangerous question

There is plenty of debate on whether professors, neighbors, friends, whoever else, should have gotten Jared Loughner “help”.  Certainly, the his mug shots with their absolute alopecia (self-imposed) look grotesque enough.  Authorities are going back through his YouTube and Myspace postings and finding reasons to discern his derangement. 

I can understand that the Pima community college decided his video was over the top (given the accusations it makes), but now the video now makes a point: you post at your own risk, and others may make unfounded (or well founded) judgments about you based on the content of your posts.  We’ve talked a lot about this before, as part of the “online reputation” problem. Schools need to pay a lot more attention to teaching it.

Given the cultural norms of a community in a particular period of history, a person’s cohort can decide that a person’s statements or behavior are unacceptable and demonstrate a need for “help”.  As I explained in an earlier post here Nov. 28, 2006, the College of William and Mary back in the fall of 1961 decided that my “behavior” was potentially self-destructive and unreasonable. That determination could not have been made in more modern times.

Nevertheless, I remember the horror of the moment. I remember a Dean of Men telling me, “You don’t want any Eastern State psychiatrists” when I just wanted a “signoff” so I could come back to school.  I wound up going to George Washington University and “living at home”.  But then I was “quasi-hospitalized” in Unit 3 West at the National Institutes of Health, Clinical Center, from July 1962 to January 1963, allowed to go to GW in the evenings “on pass”.  (I was the only “patient” so allowed; so I was the only patient who knew about the Cuban Missile Crisis in October 1962.  What a time this was.)

It has been easy for me to pooh-pooh the subject of mental health over the years.  It’s easy to attribute it to prejudice and ignorance. There were plenty of euphemisms around. “Nothing to be ashamed of.”  Oh, really?  How are you feeling, mentally?

In more recent years, given the way my eldercare situation unfolded and developed (I’ll have more details about this soon), I’ve developed more appreciation for what those therapists back in 1962 were really getting at, despite all their flaws (including smoking during individual therapy sessions; I’ve never smoked).  They were worried about overinvestment in “fantasy”, and in the ability to make the fascinations of the moment (as sometimes found in what psychologists call “part-objects”) into whole internal worlds.  (I can see how this connects to the psychological underbelly of the two-decades debate on gays in the military.)  The typewritten notes on my care (I have all my medical records from 1962 from NIH) are quite graphic on the particulars of this.   On a certain level of theoretical physics, I guess, “dreams” and “fantasy” have a realness “somewhere else”; perhaps some day we will prove that “cold souls” can jump between universes (by changing space-time) even though ordinary matter and energy cannot.  (Hint: take religious concerns about the Afterlife seriously!)  Nevertheless, the explosion in the need for eldercare and the calls for “resocialization” because of “sustainability” concerns, make me question the moral validity of the “schizoid personality” and his situation; his life means nothing until it meets the real needs of other people. I wasn’t ready to do that at NIH, and sometimes it seems I’m barely much more ready to do that today.  Employers with needs for people with esoteric mental skills, say in intelligence work, have to grapple with this all the time.  People who are too eccentric and lost in their own worlds may present the (totally unpredictable, as Dr. Phil said on AC360) “lone wolf” danger, but sometimes (as agencies like the CIA know) they are the only people with the peculiar talents to do the work necessary.  But to “not need a relationship” is not such a good thing, it seems.

So much for today’s non-poetic ramblings.

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