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Tuesday, September 25, 2012

Survivor of gay mental illness treatments in 'Out' magazine

Feature story by Justin Torres, 'A Family Outing,' Out magazine, September 2012 p, 88
PHOTO: Feature story by Justin Torres, "A Family Outing, Until recently, people thought homosexuality was a sickness. The story of one man who survived the 'cure,'" Out Magazine, Sept. 2012, p. 88-93, 135 -- Torres was declared mentally ill for being gay, which he played along with for awhile. (A free link to this article appears to be unavailable as of this posting.)

This is an excellent first person account of gay man's struggles with being gay and other people convincing him he was mentally ill. Although being gay is no longer defined as a mental illness, it is clear that many of the issues Justin struggled with are still shared by many young men today and they could easily repeat Justin's decision to play along with the idea that they are mentally ill just to accommodate societal homophobia.

Justin was born in 1980 and became depressed at the age of 17 not wanting to be a "fag." He modestly says he was a "deft kid" who was able to politely humor the psychiatrist that his mother insisted he see regularly. From that experience and from independent reading, he had figured out the magic words that would allow the mental health system to lockup somebody: "I needed only to prove I was not a threat to myself or others, and they would be forced to let me go.

Justin then freely admits how at a low point in his life, which he doesn't recall clearly, to having made threats that he knew would result in himself being involuntarily restrained by "multiple white coats." He recalled, "Doctors asked me absurd questions and I answered with hostile and absurd answers. I put on a show, I dredged up every painful thing I knew about my folks and I hurled words at them, the most vicious language possible, while the doctors looked on. I wanted desperately to shame them. And did I want to die? You're dam right I wanted to kill. You're damn right I wanted to die. And they locked me up."

Although I will concede that I've witnessed mental illness cases that appear to be truly caused by some unknown physical defect in a person's brain, Justin's case is a more ambiguous one, which in my opinion is a good example of the more common situation where well meaning mental health practitioners do more harm than good. With perfect hindsight, it is clear that Justin didn't need to be locked up, but instead only needed to have unconditional support from his parents and the mental health system so that he could realize he was "not crazy" and only needed some help in getting over the anguish that he shares with every other intelligent queer boy who is ostracized by the homophobic "normal people" in society. Of course, I realize that unconditional support will not help the truly mentally ill, but it is clear, with perfect hindsight, that Justin is not and never was mentally ill -- he was just a creative smart gay boy who was shunned by those around him and he was emotionally wounded by it.

Torres provides a brief history of the past when being gay was classified as a mental illness and how it was eventually removed from the official list of Mental Disorders. Although the history he states is accurate, he omits some of the context that I learned firsthand from having lived through that period in history. The famous psychoanalyst Sigmund Freud invented theories of how the mind worked and he hypothesized that the mind was malleable because, by definition, it is capable of learning and therefore its behavior could be changed through psychotherapy. This theory was widely accepted at the time by most, well meaning people. Even today, most people are ignorant of the arguments between a person's chosen behavior that is considered criminal versus a behavior that the involuntary result of a person's genetics or biological makeup. In mental illness cases, it is often not clear what is voluntary behavior not caused by the illness.

The popular Freudian theory of homosexuality in the 1950's and 1960's was that homosexuality is caused by a boy having been raised by a domineering mother and a weak or absent father. The idea being that a boy learned how to be a man from a strong male role model. Numerous counterexamples to this theory have demonstrated that it couldn't be the sole reason, if it was the reason in any case. Various mental health treatments for homosexuality and the efforts of religious based ex-gay groups have tried to "cure' gay men by trying to teach them how to be more masculine. A few ex-gays have claimed these methods worked for them, but some of these same ex-gays have then been later exposed as still being gay and nearly all ex-gays will freely admit to having settled for celibacy or abstinence because they still feel a desire for same-sex sexual activity. This means that sexual orientation is partially a chosen behavior, but the homosexual arousal behavior also has a strong genetic component that is not learned or chosen.

The diagnosis of mental illness is treated with great skepticism by society. Many people worry that mentally ill people are pretending just so they can assume the sick role and escape from the duties society expects them to perform. In fact, historically most health insurance providers have assumed that all mental illness is malingering and therefore they do not cover it adequately. Of course, those who think they will get out of any responsibility by pretending to be mentally ill, will soon discover that it won't get them out of anything and in some cases it will cause them greater problems because they will be harmed by the drug treatments for mental illness, which are popular today, and also harmed by the stigmatization, which comes with being labeled as mentally ill.

I was also skeptical about the existence of mental illness until when I had my first brain stroke and it was scientifically confirmed with an fMRI (functional magnetic resonance imager that can measure individual blood vessel flow rates in the brain and show where blood flow is inadequate). Many of the signs and symptom I had (e.g. delusions and hallucinations) could have easily qualified me for being diagnosed as mentally ill. Of course, I was smart enough and my doctors were smart enough to dismiss this diagnosis. However, so-called "mental illness" was not ruled out entirely until after my stroke had some tissue in my brain and all of these symptoms instantly disappeared and replaced by low vision blindness, which is a diagnosis that is considered to be a "organic illness," instead of a mental illness, by medical doctors. This different diagnosis matters legally because most health insurance policies will cover so-called "organic" medical disorders, but not fully cover so-called "mental illness." This bias appeared back in the Freudian days when treatment for mental illness involved and numerous expensive sessions with a psychoanalyst. Nobody wanted to pay for psychotherapy because mental illness was not considered to be real by most people.

Sadly, the bias of no medical insurance coverage for mental illness persisted even after it was discovered that certain psychoactive drugs, unlike psychotherapy, could help some mentally ill people get better. Nobody yet understands exactly why these treatments work, but if they are proven to work and safe, then they should be covered by medical insurance.

Clearly, as medical science develops a netter understanding how the brain works, I am sure the artificial distinction between physical and mental illnesses will vanish. Yes, there will always be some things that can be solved by talk therapy or by teaching and learning coping skills, but I am sure that doctors will become better at figuring out if it is the hardware or the reprogrammable software of the brain that needs to be fixed. See my previous posts and these related links:

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