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+2 votes
In general, i'd say @s value mental autonomy and resist the tyranny of psychiatric institutions. Further, i think there is often value in communicating with non-neurotypical (whatever that is) people. Often psychological distress can be caused by some fucked up aspect of society. The psychologically damaged (and, really, who among us isn't?) often hold insights that others cannot see. Usually the field of psychology acts to reinforce the presence of capitalism and other oppressive crap by not questioning these fundamental social ills, and reinforcing the role of pharmaceutical control. We are right to be wary of endorsing the psych industry.

But what if someone we must interact with has extreme psychological issues that are unaddressed? How might they get help without submitting to some psychological authority? How can we respond to their problematic behavior without trying to get them medicated by force or locked up in a psych ward?
by (6.1k points)

2 Answers

+2 votes
Firstly, "psychological dammage" implies an original, ideal psychology that gets dammaged by this society, which is itself a baseless, neurotypical position.
To answer your specific question, it depends on the circumstance. The best thing you could do would be to make sure they know that you're supportive and maybe point out some alternatives to being locked up, like the use of drugs (either procured illegally or through a psychiatrist), meditation and exercise. More importantly, help that person to change their life in a way that means they're less alienated and stressed.
by (270 points)
edited by
Some people do suffer psychological damage - I have friends with PTSD due to all manner of fucked up shit that has happened to them. Some of them also suffer from severe depression (not the get some exercise and meditate type- not that these things don't help, to a degree - but of the ongoing and pervasive type that renders them deeply unhappy). I think this is a normal reaction to the myriad traumas we might face, given the shit we are born in to. Whether it is about abuse, oppression, gender (I know, criticize me now for identity politics!) or just that the world is generally fucked. When I used to work with homeless youth, those not suffering from at least mild depression always raised red flags for me because, given all they faced, if they weren't somewhat depressed, or having a behavior disorder then likely they were masking something much deeper.

Which leads me to the second category of people potentially dealing with psychological duress: Some people don't have what is necessarily "damage" but are, as you say, non-neurotypical (though that term makes me cringe). Folks who might be diagnosed with bi-polar, clinical depression, schizophrenia, schizo-affective (aka when old enough they'll be diagnosed with schizophrenia), and those on the autism spectrum might fall in to this category.

How we deal with them would likely depend on which of the two categories (or both) and what combination of behavior you are dealing with. Generally speaking, everything Animalevolent says is good advice. Some more particular things that I have gleaned and which may or may not be useful given your situation:

1. Don't pretend to be a mental health professional if you aren't. Diagnosing others isn't helpful, and if done in any public manner, could be the equivalent of badjacketing them. If there is particular behavior that needs to be addressed, address that, but don't throw around terms that are often diagnoses as pejoratives.

2. Stay flexible - the DSM IV and the diagnoses in it are merely ways of generalizing about individuals psychology, based on observed patterns. Schizophrenia looks different in different people, and it is not a particular set of symptoms, but a correlation of a certain number of attributes that *might* be schizophrenia. The same is true of most other diagnoses. That means not everyone reacts the same to the same coping/treatment/wellness plans. Someone might seemingly present with something, and that is not what it is. Also, they might have a particular diagnosis and not react the same way as others with the same diagnosis.

3. Be real - I used to know a guy who was severely schizophrenic. I don't mean that as a pejorative sentence - he was kind, creative, and an amazing poet and artist, as well as someone with the potential for the most intense empathy and sensitivity that I have encountered. He also saw geometric patterns that spoke to him, and at times viewed himself as a messianic. When I first met him, I would go along with whatever he said so as not to "upset" him. Over time, I realized that he actually found it more helpful when I would just tell him, "I don't think I follow you." A common acquaintance once indulged  one of his hallucinations of voices, at which point he looked at her with wide and confused eyes and asked, "you hear them too?" He was not, in that interaction, looking for validation of his experience, but a touchstone as to what others are experiencing. Falsely claiming common experience is doing no one any good. On the other hand, the young mand who had a "ghost" that helped him through his daily routines and gave him positive reinforcement about himself so he could (hopefully) get through his day didn't need people actively telling him that the old man ghost wasn't real, seeing as how this was one of his most positive relationships.

If someone you interact with is in need of further care than you can provide, to help them get that help would hinge on what is happening right then. If possible, getting them to a quiet place with less people (not necessarily alone, though most people in sever psychological distress aren't a threat to anyone, it is a good idea to have someone to have your back) is going to help. Try to roll with what is going on, but also try to assess how much consensus reality you share; knowing this will be crucial to connecting effectively. Use easily digested words and sentences, without condescending. Express whatever concerns you have for their safety, and see if you can come up with a plan with them for what to do. Depending on where they are at, this might not be to get "help" so much as it is to cope or stabilize for a bit. Since you can't and presumably don't want to force them to get any help they don't want, the best option is to help them in the moment and address it later.

There is a lot more I could say about this, but I don't know how much is relevant or necessary.
while there is a lot i agree with in what you say, ingrate, there is absolutely nothing in what you say that is specific to anarchists/anarchy, and the idea of taking the dsm seriously in *any* way (other than as a way to manipulate social workers in some possible scenarios) is directly counter to any anarchy i recognize.
as has been stated elsewhere, there can be a fine line between being a 101 site and being an advice column, and your answer is firmly on the advice side.
my preference is that you make this a comment, since it is not actually an anarchist answer (though it may be an anarchist's answer ;) ).
Agreed about the DSM, which is what I was trying to point out in talking about it the way I did. You are definitely correct that this is not a specifically anarchist answer, so I'll happily convert to a comment.

(adding more characters for minimum)
so.many.typos. You'd think the spell check underlining would help me, but alas, no.
ingrate is spot on with their advice.

As for an "anarchist answer", it depends on what the situation is, and if it's a crisis needing immediate attention, which is often the case.

If the person is suicidal, then you need to watch them and get them in a safe place where you can prevent attempts at suicide and where you can talk them down from where they're at. Oftentimes, attempts at suicide are a  cry for help, so treat it as such. If you have a local suicide prevention hotline, try giving them a call if they can be trusted. Do not call the police unless you want an assisted suicide, or unless the police can be trusted to act in a helpful and appropriate manner.

If it's PTSD, then there's been some sort of traumatic stress in their life with which they are unable to cope. Here's some good street medic advice on dealing with PTSD:

If it's organic mental illness, such as schizophrenia or bipolar disorder, the person may have stopped taking medications, either because of side effects or they can't afford them, or they missed a dose and they aren't thinking straight. They probably need to see a professional provider and have their meds adjusted or changed. This is a situation in which the best thing you can do is keep them calm, don't feed into their delusions or agitation, and get them to an ER ASAP. If you can't do this for one reason or another, try these Bach Flower Remedies:

Bach Flower Essences:
White Chestnut... unwanted thoughts, preoccupations and worries. Teaches a balanced state of mind and the ability to use one's thoughts constructively
Cherry Plum... fear of losing control and of irrational thoughts and/or impulses
Mimulus... fear of known things
Star of Bethlehem... trauma and shock, whether experienced recently or in the past. Teaches the ability to recover from traumas and integrate them into the present life
Olive... emotional burnout. For mental and physical exhaustion caused by illness or personal ordeals. This remedy assists in giving strength and vitality
Rock Rose...terror, sudden alarm, nightmares or situations in which one experiences panic
Dosage: 25-40 drops, 3 X daily, beginning asap after a traumatic event

You can get these at a health food store.

Here's a story about a case of schizophrenia treated successfully by homeopathic medicine:

Other good street medic pages are:
+1 vote
I think this is a classic question in a specific context: the question of medical authority and treatment. If someone is infected with a disease you don't know how to treat and they are unwilling to be treated for it by someone that does know how, that is their choice and I think that from an anarchist perspective it ought to be honored. But, the question is complicated by the nature of psychological 'issues' and it's very difficult to provide a general answer. But let's get real about this... the history of how human beings have understood and responded to what we really do know now to be biologically reinforced psychological problems is shitty - really shitty.

So what complicates the question? The fact that someone's "choice" may not really be authentic. Ok, that sounds fucking elitist but let me clarify with an example: if I wanted to kill myself tonight and you knew that it was likely I wouldn't want to tomorrow and for a long time afterwards, I think intervention in my episode would be appropriate. What is important to emphasize is the recognition of how flippant my desire seems. There's a possibility that I finally worked up the courage to do it after a long period of contemplation; but, in that scenario I would think there really wouldn't be anything someone could do to prevent me from killing myself and the intervention would just be a delay - not that big of a deal. So while in that moment I may authentically want to kill myself, in general that is not really what I want to do and I may even be covering up a desire to be more lively, more in control of my life, etc. more than I really want my life to end. So, the value of individual agency is complicated by the fact that we don't always really act on our most general desires... or even our real interests.

So to get back to "getting real" what are the probable choices? Letting someone you care about or your community suffer, intervening into someone's relationship with themselves, killing them (maybe they're possessed by demons!), trying to personally delve into their world without the psychological tools that have developed over the past couple centuries, or trying to convince them that someone with those tools who may or may not be fulfilling the role of enforcing conformity with consensus reality can help them better. When you look at these choices (and sure, I may be missing a few), it seems clear to me that an anarchist ethic would be to do the best one can to take someone like ingrates advice... or because we don't have a solid mutual aid way of really helping people with severe psychological issues (let's face it, Soma Therapy and the Icarus Project only address some shit) to do what we have to do in this world: be fair with them in addressing your concerns and if depending on what you're dealing with, find someone who really knows how to help.

The problem really isn't that anarchist concepts of authority and consent create an ethical conundrum. The problem is that there isn't a mutual aid network for many issues. There are plenty of meet-up groups for a variety of people who are able to get out and socialize... though there's problems in that area because it's likely that the norm will be something like a bunch of people who are under psychiatric care and that may have the consequence of someone becoming convinced that not only do share the same issues, but they ought to share the same solutions. Regardless, who the fuck is to say that anarchists wouldn't be acting in an authoritarian manner via negligence due to ideological purity or some half-backed theory of human psychology? Aren't you already putting yourself into a position of authority by even taking up the question of someone else's problems? Is it a legitimate position to be in? It seems to be when someone is knocked out because of a tear gas canister to the head, when someone is getting beat up by neo-Nazi's, etc.

This is one of the things I really respect about Chomsky... his concept that the burden of proof is on the authority to convince someone of their legitimacy. That authority ought to always be challenged but in some cases it does seem appropriate. If it isn't, well then hopefully the authority will be critiqued and that critique will turn into a solution that doesn't require an authority. Anyway, that's my two cents. I personally have rushed a friend to a hospital when they attempted suicide and confessed later that they were having second thoughts. I didn't know how to get the pills out of his system. So whatever - I'd rather be a "bad anarchist" than know there may be help for a comrade and out of some abstract ethics, not attempt to find them help.
by (2.5k points)
you and ingrate both abandon theory in the face of the "real world"-ness of this question. theory is still your friend, don't dump her so quick.  (theory is ideas about how we want to live and how we do live, right? so real life experiences are part of what makes good theory, right?)

what makes a theory of human psychology half-baked? aren't all theories half-baked? isn't everything we do contingent and a work in process?

people decide to kill themselves, or threaten to kill themselves, or try or seem to try to kill themselves, for many reasons. one of the reasons is that it is one of the few ways that people will believe that they're serious. what does it mean that this is what it takes (when it works) to be taken seriously? what would it look like for us to actually respect the decisions that people make about their lives, including the one to end it? why do you think that someone changing their mind (about killing themself) is not a symptom of them caving to social pressure? what would it be like to view someone's suicide as a celebration of their willfulness and self-determination?

the question here is both a conflict between autonomy and anarchist ideas (i have said before that i think this is the major issue for anarchists), *and* the need for context whenever figuring out good responses to situations (whether it's a suicidal friend or what you want to have for breakfast).

*edit: how is your answer different in substance from animalevolent's?
There is a need for context because psychological problems can be many things... including conditions like catatonic schizophrenia. And I have no idea what "extreme" means in this question. What stands out to me are two things: the first is that like a number of other situations I can think of off the top of my head, considering what to do about someone else's behavior is already positioning oneself to make a choice on another's behalf; the second is that I think that just like with other forms of medical care, anarchists could and have come up with models that don't rely on institutions we're opposed to (Soma Therapy being one example).

Maybe "half-baked" is the wrong term. Someone can have a lot of theoretical assumptions about human psychology or critiques of psychiatry without ever having thought of how to apply that theory. I don't know if that is what I was thinking when I wrote this response. I'm not suggesting the abandonment of all theory, but I am suggesting that generalizing the principal of autonomy can't account for a number of situations.

As far as suicide goes, I don't have an ethical problem with it in general. I do however know what it's like to personally experience psychotic depression that was caused by a bad cocktail of psychiatric drugs and I am pretty happy that instead of killing myself I got off of them. In the situation I mentioned, the person changed their mind on their own and drove to where I was at ...pulled me aside, and basically explained that they fucked up but were afraid to go to the hospital because they didn't want to get their stomach pumped (which fortunately, they didn't have to because there was an antidote to what they took). I have also had numerous friends that have killed themselves and I don't think they did anything wrong.

Anyway - I like the idea of support groups, I don't think someone's autonomy is being disrespected by telling them that some of the things they are doing are affecting you/others a certain way, and I think there are genuinely times when either by accident or by choice people wind up in situations where someone else's fate is in their hands or autonomy/consent is difficult to determine ...and it's extremely complicated to decide what is ethical from an anarchist perspective.

edit: I just noticed that I said ingrate instead of animalevolent. I'll have to re-read their answer.
- edit 2: I guess it's sort of similar?
"Aren't you already putting yourself into a position of authority by even taking up the question of someone else's problems? Is it a legitimate position to be in?"

This is the fundamental dilemma. As with the more specific question I outlined, it is context-dependent. There are cases where the individual's problem becomes a group's problem, in which cases this position becomes pretty much unavoidable. There doesn't seem to be an easy answer, but i appreciate the responses this question has elicited. I suppose that in general, we might say that in group contexts often the appropriate response is to exclude the individual in question, if they refuse to own up to their problems. However, (as many of us know too well) it is often painful and embarrassing to be outed for our particular psychological makeups, and our efforts to change may not be recognized by groups we are part of.

I also want to point out that i am not interested here in advice for the particular individual who inspired this question, and thus have not inquired their particular condition (tho it does raise a lot of interesting questions for me about the larger psychosis of this society!) This person is actually quite reclusive, so their particular condition does not impinge on other humans as much as others might. Maybe this question is a bit too abstracted from our actual lived situations.
I think it's a dilemma for coherency but I don't really think that anarchist principals or whatever you want to call them are meant to be these sort of moral absolutes that are at all times and in every sort of social dynamic appropriate. Some of this seems to function in the same confusing way that the rhetoric of the 99% does. Anarchists are definitely opposed to authoritarian systems, methods of organizing, models of interpersonal relationships and family, etc. but being in a position of power over someone else in these situations (saving someone from drowning, feeding an infant, expropriations, any sort of fight that doesn't amount to a tie, etc.) aren't always avoidable and when it comes to group conflict, revolts, and such it's pretty damn difficult to break out of the way anarchist theory is often packaged. Let me elaborate on this a bit because it has been frustrating me a lot lately...

Here's a version of this dilemma: the pacifist vs. someone willing to use force debates. So the pacifist can have some view that to use force is to exercise authority and is thus a conflict with some anti-authoritarian or anarchist principals (however convoluted, and this is hypothetical it's not an analysis of pacifism). Then the response is something like, well it's self-defense, pacifism just puts the burden on others to use force for whatever, maybe some categorization of people which makes force in some circumstance acceptable. Either way you get this situation where authority is in a round about way being argued for. The pacifist can go on about how they have an evolutionary, education approach as though the power to teach isn't tied in with authority. The revolutionary can go on about prefigurative politics and defense of gains or whatever they want. But both of these characters are approaching life from this sort of grand narrative insofar as what they're opposed to and what they support, the history of other people who thought similar things, etc. They're basically trying to distill from their analysis and critiques something general about all of them... calling it authority, and then focusing on this generality that now they can pick out in other institutions/etc. as the big thing to avoid in a very absolute manner instead of as a potential guideline for various choices that they want to make together or individually.

Ok, so anarchists have hit the nail on the head when it comes to how fucked up authority and especially institutionalized authority can be. But, the nuts and bolts of what anarchists critique about the State, Capitalism, the Party, Civilization, Patriarchy, Hierarchy, etc. and how anarchists have responded when informed by such critiques doesn't neatly square with always being opposed to authority no matter what (or whatever). And why should it? For as many different anarchist perspectives that have come and gone, I think it's arguable that the reason for the label "anarchist" was and still is but not always to distinguish oneself from other socialists or the Left (or whatever). So from the beginning of anarchist as a term for various positions on shit, it was people distinguishing themselves by emphasizing the anti-authoritarian of their own positions and the authoritarian aspects of others'.

Well wtf... so because that was a defining characteristic of anarchist theory all of the sudden it's appropriate to apply the same criteria to every dynamic in the universe? To the point where being considerate (putting yourself into a position of authority by taking up someone else's behavior as a personal or collective problem) can even seem hypocritical?

Anyway - I'm not frustrated with you enkidu and I realize you weren't looking for advice specifically because you didn't provide much context. I think it's a good question to ask. I feel in question about this sort of thing often and it's a humbling reminder that I have plenty to learn and think about.
"one of the reasons is that it is one of the few ways that people will believe that they're serious. what does it mean that this is what it takes (when it works) to be taken seriously? what would it look like for us to actually respect the decisions that people make about their lives, including the one to end it?"

I wish this was a question on @ 101 itself. What does it mean to live in a world where you feel like you are driven to fucking pay someone to listen to your emotional shit and help you try and figure stuff out? What does it mean to feel powerless against forces in your social life which consistently offer the basic message that your "baggage" is practically insufferable so the most considerate thing to do is keep your mouth shut? What does it mean to be in conflict about the desire to respect other people's decisions and the sentiments of outrage felt towards the way in which deep desires for acceptance, affection, and sympathy are suppressed in favor of "cool"? If suicide attempts are a way to act on the desire for catharsis... which is a perpetual desire because of emotional isolation (however self-imposed) ...and suicide success seems like the better decision than struggling with such a situation - what does it mean to celebrate that decision instead of fighting to carry on someone's struggle against such forces? And what of those whose self-loathing is so deep that they figure that they deserve to suffer such conditions?

Heavy shit Dot
i only just saw this, gdmt.
but yes, heavy shit indeed.
luckily the short answer is that we're too fucking complicated to tie a ribbon on; and that is probably the only reason to have any kind of hope at all at this point.
if there is any hope.