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Tsunami and Me

Tsunami and Me
too big to escape now....

Tuesday, February 20, 2018

On Mental Health: Letting the Sun Shine In

A longtime friend and fellow licensed clinical social worker, Christine Johannson, posted this on Facebook, and gave her permission to share it widely. Thanks so much, Chris, for contributing to the discussion of what mental health issues can and should be addressed.

"I have been a counselor for over 30 years. I believe counseling can be life changing. I believe that early intervention can help high-risk children and may prevent them from developing the kind of deeply twisted psychopathology that we see in many of the school shooters. What I do not believe is that more mental health services will fix the immediate problem of mass shootings.
"The term 'mental illness' covers a lot of turf and this causes a great deal of confusion. Those who suffer from acute disorders such as bipolar and schizophrenia can respond well to counseling and medication. But, for the most part, these are not the people committing these shootings. Most shooters are people with a different, much less treatable, kind of mental illness. They suffer from characterological disorders, such as antisocial personality disorder (AKA sociopath) and malignant narcissism—disorders that profoundly distort how they see and respond to the world.
"Mental health providers have a dismal record of treating this group—not because we haven’t tried, but because of the nature of the illness. These disorders seem to start in early childhood, causing a serious distortion in how the person perceives and interacts with others. These are folks who have little or no insight (they don’t see that they have a problem, but instead blame others), and they have no empathy (which is why they can carry out these horrific attacks without remorse). They lack a conscience and you need a conscience for most therapy to work. Since they see others as the problem, they don’t believe they need to go to counseling (why can’t others just change?). When they do go, they tend to be dismissive, manipulative and take no responsibility for their behavior. Even if the person managed to find one of the few highly skilled therapists that can deal with this difficult population effectively, the likelihood of the person staying in therapy for the 1-3 years needed to undo the significant damage that caused the disorder are slim to none. Change is hard and requires an ability and a willingness to acknowledge our dark side and do the very hard work of changing it. Asking a sociopath or a profoundly narcissistic person to do this is like asking a pig to fly.
"Even if we let go of the idea that counselors are going to magically fix people with these severe disorders and just focus on having them identify those who are dangerous, there is still a problem. This type of client is a counselor’s worst nightmare because we are aware of the potential danger they pose, but we cannot involuntarily commit them to a psychiatric hospital unless they are 'an imminent threat' (they have told you of an plan and you have reason to believe they could carry it out). You cannot take away someone’s civil rights and lock them up because you have a bad feeling about them, even if that crawly feeling is spot on. As a counselor, you do your best to give resources, to provide a safety net, to get them additional support (things that can actually help with people who do not have a personality disorder, but aren’t really that effective when you are dealing with a sociopath or a malignant narcissist). Then you pray that you don’t wake up to see their face on the front page of the paper in connection with some horrific crime.
"What will help? Not allowing the average person to have access to weapons of mass destruction, weapons whose only purpose is to kill the most amount of people in the shortest time. We simply have no accurate way to identify those who will use these weapons to commit mass murder, and, if we could identify them, we can’t watch them 100% of the time. The bottom line is that none of us need to have weapons of war; thinking that we do has created an unlivable society with an intolerable level of carnage. We can buy back the weapons that are out there and confiscate the black market ones as we come across them. Is this a perfect solution? No, but it is the only one likely to have much of an impact. We can’t keep all people from driving drunk, but we still have laws and stop those we can. We can’t stop all people from abusing their children but we have laws and we try. There is literally no other destructive behavior in our society where we shrug our shoulders and say that since we can’t completely fix it, let’s do nothing. We are all sick to death of hearing these stories of tragedies that we can prevent. Let’s do something this time." --Chrisrinw Johnnaon


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