Schizophrenia: A View Within

Schizophrenia: A View Within

Jean McBride

January 20, 2010

Abstract

Maladaptive behavior comes from various biological, psychological, and environmental occurrences. The theories involved help students acquire an understanding of the deep-seated behavioral needs of prospective future clients. Mental health services, in the young deaf community, have many issues pertaining to providing adequate care. Living in profound silence, 43% of deaf youth struggle to prevail in life with mental illness. Counselors and psychiatrist are sacrificing to meet their unique needs. Prospective treatments and theory of behavioral modification can only help if one understands the causes and issues related to the illnesses. This is a look at the deaf culture, their mental health dilemma, and the sacrifice developing to accommodate the silent world.

Schizophrenia: A View Within

The human organism is susceptible from conception to death for varied alterations, which effect behavior and thought. Mal-adaptation is often a replacement behavior that occurs as a result of the alteration in thought pattern. Schizophrenia is considered to be a maladaptive behavior brought on by various causes still undergoing investigation. (NIMH, 2009)

Biological factors would include such issues as genetics, disease, alcohol use of parents or self, other substance abuse, and chemical poisoning, as well as structural brain abnormalities or injuries that effect behavioral outcomes. (Sarason, 2005) Genetic defects can include a predisposition to varied brain disturbances. (Comer, 2004) These can be passed from generation to generation and may become determinable at conception or even before. (Comer, 2004) Genetic testing for various probabilities has a long way to go. (NIMH, 2009) Present information states there is a “genome scan” for determining some of the variations of genetic predispositions for schizophrenia, but it is not completely accurate. (NIMH, 2009) The concept that it can be found is one issue and the determination of the best way to fix the occurrence is far in the future, if even in our lifetime. Genetic engineering is full of alternate ramifications and ethical considerations that will no doubt be the manifestation of a super acquisition of legal and scientific laws such as is beyond our present imagination.

Disease in infancy, childhood, or adulthood, can cause damage to the brain in various ways. Encephalitis causes inflammation to the brain usually after a viral infection or preceding a vaccination for proposed serious illness. (NINDS, 2007) Ischemic Stroke causes brain damage when the blood vessels in the brain become clotted, blocked, or plugged. The perpetual stress on blocked veins builds as the blood continuously pumps. The vessel gives way becoming a hemorrhagic stroke, which bleeds into the brain causing damage. Transient ischemic attacks (TIAs) happen, when blood supply is interrupted in brief increments. The ramifications of stroke can cause somatic conditions, yet the unseen and often less noticed effects are alterations of mood, thought, behavior, and even change in personality, thus causing mental conditions or disorders. (Satcher, 2007)

Traumatic brain injury (TBI) happens when forceful impact to the head causes damage to the brain. TBI can leave many lasting mental effects, including such behavioral/mental health challenges as depression, anxiety, personality changes, aggression, acting out, and social inappropriateness. TBI’s are on the rise with the war as are maladaptive abnormal behavioral issues, whether from the tragedy of war and survival or the injuries incurred. A soldier’s symptoms may also overlap with Posttraumatic Stress Disorder, making it more difficult for doctors to treat. (NAMI, 2009)

One considering the alcohol and substance abuse or use must consider the affect on infants and children first as the mold is made or broken in childhood, even infancy. Guided more so internally by the genetic grid, an embryo is formed. If the parent drinks while pregnant, there is an effect. The genetic makeup carries what has been the past as well as the future is embolden in every cell. Was the Grandfather predisposed to a mental illness such as schizophrenia or maybe depression? Thinking about this aspect of the human experience when considering brain function as well as the varied genetic issues of other possible configurations that make an individual what they inevitably are is amazing to say the very least.

Psychological theories include Freud’s theory of psychodynamic motivators for maladaptive abnormal behavior. This is the mental law that random thought is guided and connected by underlying motives, conscious, or unconscious that causes the behavior to be validated or rewarded. (Westen, 1998) The theory of instinctual drives such as: sex, physical urges, and aggression, manifest to mold maladaptive behavior that forms into anxiety or personality abnormalities. (Westen, 1998) The conflict between the id, the ego, and the superego, continually cause emotional friction in an already at risk individual, thus wearing down the normal ability to adjust in some circumstances and causing abnormal adjusting in some situations. (Westen, 1998)

Another factor, which should be considered, is environmental. The environment that one is constantly in affects the mental state of the individual. Chronic violence, poverty, excessive worry can cause anxiety or personality abnormalities. (NIMH, 2009) Posttraumatic Stress Disorder is a stress related illness from extreme trauma such as war, rape, or extreme violence. It is interesting that those reared and continuing life in normal, quiet, peaceful, situations have lower instances of mental illnesses. (NIMH, 2010) Racial and cultural divisions that are stressful can bring about personality and other possible sensitive counseling needs. The environmental impact of variables on mental health can be many with divided impact. The goal should be to aid the client in overcoming and integrating, thus becoming empowered in their own positive traits building the self-confidence they need to continue. (NIMH, 2010)

Struggling with Schizophrenia (295.30), PTSD (309.81), Manic Depression (296.33), as well as other numerous mental and physical challenges that at times are very crushing have taught this author about survival and the creative nature of the human spirit. The desire to do better despite the issues, to create a life from the ashes at 42, to reach out and find a way to overcome maladaptive behaviors that alienate and cause division between clients, their families and society is ever present. The blessing of therapist and psychiatrist, who have walked the roads of mental illness and social stigma, is priceless. This author has taken a 28-year span of successes and failures in a life with mental/physical illness and taken charge with the use of self-help books, research, medication, therapy, good doctors, and constant awareness of new and better medical management to find a better life. The days are scheduled like everyone’s. They are often exhausting, sometimes overwhelming. Unusual family issues and extreme stress with the muscle disease that is prevalent often overwhelms this author. Medication for pain and anxiety is limited to non-narcotic by choice, being able to think clearly is most important. The support structure present that is the best and most supportive is the doctors and therapist rather than family. This course has been very helpful in the journey to become a psychologist and better understand the behaviors of those so affected by the same issues that molded the views this author has carried for years. There are others though who struggle silently, in a world of quiet repose, where therapist and doctors have a language barrier. The deaf face amazing challenges in the mental health system.

Voices in the Silence: the Interview

“The voices tell me to cut myself. It makes me feel… feel as if I have control over just one thing in my life.” Suzan replied in sign language, when I signed to her about her schizophrenia and cutting ritual. She is 17 years young. A prominent student in high school, she also was in several extra-curricular activities. The schedule in front of me was staggering. “When I take my medication I have better days. I like to stay busy; it helps me to deal with the inner problems,” Suzan continued. “I am lucky; we have a counselor at school, which referred me for services, so many people receive no help at all.” She is not alone fighting a severe mental illness. Her plight echoes throughout the young deaf community.

Mental illness issues affect 43% of the deaf youth in America. (Eldik, 2004) The illnesses range the full gamut, from depression to schizophrenia; all of which are very hard to treat in the hearing community, under the best of circumstances. Medications and therapy treatment assigned for the group must be changed and altered to get the right balance. Communication is imperative to this process. (Carlson, 2008) Chemical consistency in the individual is remarkably different from one person to another; balance in the brain enzymes and medication application can incur many trial and error efforts to discover what works best, with the least side effects. This author’s treatment and observations through the last 28 years of mental illness still takes time and proper communication with the professionals to achieve and maintain a feasible balance. Trying and accommodating the various medications in different dosages over time to find a combination that stabilizes the illness takes patience, trust, and communication. Continuing close relationships with psychiatrist and therapist help as medications build a tolerance in the brain and must be changed to have continuing good results. This is an intricate dance between the patient and the professionals.

Communication is Vital

The young deaf community are susceptible to challenges the hearing world seem to be unable to conceive. This is manifest in the communication situation. Communication interferences in the postlingually deaf subjects determine a predisposition to mental distress. The subject observes the loss as more of a disability than prelingually deaf individuals do. De Graff (2002) found correlations in the prelingually deaf population as having a better self-image and quality of life than their postlingual counterparts. (DeGraff, 2002) Accordingly, DeGraff surmised the postlingual group felt socially isolated, less accepted by there hearing peers and more likely to have additional medical and social problems. Sign Language and speech reading in addition to written language are used to assess the deaf for mental difficulties. Various mental issues, in the hearing-impaired community, have no relative association with the level of imparity in the hearing. (Wallis, 2004) Internal and external manifestations studied in the subjects to determine the viability of treatment may gain the psychiatric personnel insight into the depth of illness. Truly, communication is imperative to the well being of the patient.

Progress serving this dynamic group of deaf marches forward as psychiatrist, counselors, therapist, and social workers are reaching out to gather and treat this vast array of people. The loving dedication of counselors and therapist learning to use American Sign Language with their deaf patients is cause for great pride. Providing translators for deaf clients is a hard job. Fifty-six percent of the deaf in one important study were unable to find accessible mental health care for lack of translators. (Steinberg, 1998) Casework and management plans effectively in place help benefit the deaf so they are able to make a fulfilling life. Positive reinforcement and patience is a virtue. Linguistic barriers often disadvantage the deaf who are able to read and write. The use of the English language for the deaf is very different from what a hearing person uses. The lack of use of conjunctions, prepositions, time continuums, and phrases cause many problems also in diagnosing adequately the specific symptoms of some forms of mental illness. Deaf think in pictorials and sign language, how does one ask, “Do you hear voices?” (a sign of schizophrenia) (Shapira, 1999) A few moments of fast signing by a patient can be seen as a manic state rather than a change in emotion. Expressions of emotions by the deaf are also a conveyance of their language; they rely on the facial expressions and body actions to understand or express the situation. This also is at times miss-read by a well-meaning clinician. The language of sign does not have adequate words for a variety of emotions; this can pose so many issues. This is why emotional behavior and facial expressions are imperative to the deaf so they gain insight. The deeper study of kinesics in the culture would help professionals diagnose illness more effectively.  The ability to test by using genome will render an amazing aid for more accurate diagnosis in cases where communication is stifled. (NIMH, 2009)

The Hope for Development

Schools and mental health agencies are encouraging the deaf to become professionals in the mental health fields. The hope for the future of the deaf culture is healthy productive individuals that direct the members of their society to prosper and strive to build a well-educated peer base. The development project in place is to increase the number of signing members in the mental health and counseling community. Adapting test for mental evaluations will also help. Time and patience are encouraged by all involved. The protocol now is to have a double evaluation before commitment, this second opinion procedure is in place to secure the diagnoses and stop miss-understandings that cause wrongful commitment.

It is a personal hope that someday the mental health services for the deaf will be as easy to acquire as it is for the hearing world. I have 28 years of experience with the mental health system and 30 years working with the deaf. I intend on having many more years ahead to continue my work. Anthropology is the study of humanity and the contemporary human diversity. I am so profoundly touched by the deaf culture as a whole. The voices in the silence are many. Deaf old and young have issues. There are answers. The best of care takes time. Time takes the voices away.

References:

Abnormal Psychology, Fifth Edition, Ronald J. Comer, (2004) Worth Publishers and W.H. Freeman and Company, New York, NY

American Annals of the Deaf 148:5, Eldik, V. (2004). . In Volume 148,  (Spring Ed.),  (pp.390-395 ). : .

DeGraff, (2002). . Mental Health Functioning In Deaf Children and Adolescents  (Ed.),  (pp. ). .

Mental Health: A Report of the Surgeon General, Satcher M.D., P.h.D., (2007) http://www.surgeongeneral.gov/library/mentalhealth/chapter1/sec1.html

NINDS Acute Disseminated Encephalomyelitis, National Institute of Neurological Disorders and Stroke, (2007) http://www.ninds.nih.gov/disorders/acute_encephalomyelitis/acute_encephalomyelitis.htm

National Institute of Mental Health: Post Traumatic Stress Disorder http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml

National Institute of Mental Illness: Schizophrenia http://www.nimh.nih.gov/health/publications/schizophrenia/complete-index.shtml – pub6

Foundations of Physiological Psychology, Neil R. Carlson (2008) New York, NY: Pearson Education INC

Sarason, I.G., Sarason, B.R. (2005) Abnormal Psychology – The Problem of Maladaptive Behavior. Upper-Saddle River, NJ: Pearson Education, INC

Shapira, N. A. MD, PhD (1999) Evaluation of bipolar in inpatients with prelingual deafness. The American Journal of Psychiatry, 156(8), 1267-1269

Steinberg, A.G. MD, Eckhart, E.A.CSW (1998, July) Cultural and Linguistic Barriers to Mental Health Services From the Deaf Consumers Prospective. The American Journal of Psychiatry, 155(7), 982-984

Traumatic Brain Injury: Veterans Resource Center NAMI:   http://www.nami.org/Template.cfm?Section=Traumatic_Brain_Injury&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=85&ContentID=52915

The Scientific Legacy of Sigmund Freud: Toward a Psychodynamically Informed Psychological  Science, Drew Weston, (1998) Harvard Medical School and Cambridge Hospital/Cambridge Health Alliance. The American Psychological Association, Copyright, 1998

Wallis, (2004) Journal of Deaf Studies and Deaf Education  2004. . In  (Ed.),  (9: pp2-14 ). : .  http://jdsde.oxfordjournals.org/cgi/content/abstract/9/1/2

Immigration and Integration: American History

 

 

 

 

 

 

 

Immigration and Integration: American History

Jean McBride

March 18, 2010

 

Introduction

People are the masters of destiny. Individuals change history for a moment or for an eternity. They make a mark at times easily forgotten or embedded inevitably forever in society, industry, politics, or culture. It is people who guide every conceivable project, movement, law and the list is extensive. The people who shaped the past also molded the present as is and shall continue. One of the various aspects of the American experience is immigration of strong and resourceful individuals from all over the world who integrated, or migrated as needed into society to create what America is today.

The history course just accomplished has focused on five periods of time from 1865 through 2008.

 

Immigration and Integration: American History

Reconstruction and Industrialization

The abolition of slavery and the reconstruction of the nation covered in the first unit saw an influx of brave, proud, hard working people. Most had seen centuries of slavery, exploitation, gross civil rights violations that were inexcusable. Unsure of how becoming free would affect the black race in America, African Americans in the early years made many choices that ensured a diversified future. Despite the “black codes” and laws to keep the people impoverished they found ways to successfully manage and own land. (Davidson, 2008) The secret ownership of Brierfield and Hurricane plantations by the Montgomery family which gave a wonderful example of hard work, desire, and dignity is an example of massive success. (Davidson, 2008) Some migrated north to find work in industries and stores or pursue education. (Davidson, 2008) The idea of working for the master for pay suited some as they felt for whatever reason home is where one needs to begin the journey. Truly there was a journey to be made.

During the time African Americans were deciding how to pursue their freedom the politics of this was in a vast upheaval. Lincoln had begun the controversial journey. History defines President Lincoln with many aspects of trying to free the slaves. (White House, 2008) Compensated emancipation was one effort, while the Confiscation Act, passed by Congress, freed slaves of those rebelling against the Union became another avenue. (White House, 2008) The most well known effort was the Emancipation Proclamation of 1863. (White House, 2008) Lincoln was a well thought heartfelt man. He ended his journey for the equality of all men in April of 1865. (White House, 2008)

Andrew Johnson was a self-made man of humble means and as President of the United States during the reconstruction period he faced an impending journey of helping the African American population gain the freedoms they so rightly deserved. (Davidson, 2008) Johnson allowed governments to adopt the “black codes” that oppressed. His innate distain for the rich clouded his judgment and gave way to a lack of willingness to work with other politicians who were striving to pass bills that were for the greater good. (White House, 2009) The Fourteenth Amendment thankfully came about despite his opposition. (White House, 2009) Thus, civil rights were not born, but the journey for the moment continued; the torch passed to people hungry for change.

The beauty of individuals is often the strength of the person within. While politics were dealing out freedoms, the business and industrial explosion of America was just beginning. Migrants from Ireland, Europe, China, and other faraway places were coming to build dreams in a land of promise. The railroads were being built. The steel industry was becoming revolutionized. People were needed to work, teach, preach, sew, sell and the list goes on.

The southern states and the West had vast natural resources as well as shared agricultural abilities that were imperative to supplying the northeastern states and central states. Poor whites, blacks, and other races were exploited by crop-lien systems, the Jim Crow segregation, share cropping, and the railroad industry. (Pilgrim, 2000) The West was also a conquest of whites slaughtering, capturing, and relocating the American Indians. Exploiting the Mexicans and Chinese for easy and cheap labor also became a mark on the land of the free.

The vast influx of immigrants coming into the insatiable whirl of industrial and agricultural jobs barely had time to settle, but settle they did. Tenements in urban areas changed to suburban areas as transportation became more available. Automobiles moved the city and suburban workers out farther into the countryside where just a few years before the farmers had migrated from to find better steadier work.  People, who were on the move; with a nation that was truly in the beginnings of changes that set the stage for the building blocks of a future that became prosperous and sure.

Politics and Change 1877-1920

Political change is a fundamental right of a democracy. It is the right of the people to offer choices. A young nation on the move had far to go with human rights and civil rights.  Women’s suffrage, the temperance league, and other movements had their roots in this tender age. (McCammon, 2001)(Gusfield, 1986) Decisions had to be made on foreign trade and territorial occupation or colonial expansion in the Caribbean and the Pacific to boost access to the rich Asian markets. (Davidson, 2008) The decisions had to be firm to keep Europe from encroaching in American affairs. (Davidson, 2008) Considering how America began, this was a prudent choice at the time.

Individuals in a democracy represent the people who vote or are politically active, thus there are a variety of thoughts and agendas throughout the political realm, even to this day. Progressivism began just as most but has had an enduring affect. The urban middle class attempted to foresee a better America from the local level up through the ranks of government. (Davidson, 2008) It was the hope that establishing a platform of social justice and social welfare would eventually balance the powers of industry and the politics that was corrupt. (Davidson, 2008) Progressivism led to the more activist government to come. (Davidson, 2008)

Man despite the very best efforts has never found a solution to war.  The pivotal year of 1914 saw a world in turmoil and by 1917 the United States joined the massive world engulfing conflict. Joining the war was necessary to preserve the interests of the country as well as the national security of the people therein. (Ibis, 2010)

The war had effects in America that were long standing. Women and many migrating minorities entered the workforce in place of the men at war. African Americans and Mexican Americans found greater freedoms in the work arena. (Davidson, 2008) The ability to serve in the military as valiant members of the forces became the lot for some. It took many years after the war for some to receive the credit they deserved.  This sad trial in their lives and the lives of the families who lost loved ones through their sacrifices in the war shows the extreme beauty in the resilience of people on the move. The motion forward can take decades for a nation and the fragility of human life is but a moment in time, yet justice and integrity as it is carried through by those left behind can make one see the remarkableness in the life that was, is, and is to come. It is the prodigy of faith in the human spirit.

Depression and War 1921-1945

Business, industry, and realty, like all entities in life are prone to cycles. Boom, recession, and depression are the natural flow of most any manmade entity. The American nation being relatively new to mass issues and thus mass management of social structure found a new trial after the First World War. (Davidson, 2008) The “boys” came home to a booming transition in American history. Amazing growth in technology, construction, manufacturing, as well as the need to succeed and move forward from the war fueled the fire of the boom. Media now catering to a mass market of newspapers, magazines, movies, and the radio improved advertising, social knowledge and awareness on an unprecedented scale. Individuals once only aware of the local issues now began a connection to the world in a more adept and profound way.  Those who had immigrated and migrated throughout the free and new lands while the mass changes where being made after Lincoln had found a way to express and connect a world, truly using the freedom.

The market crash in 1929 was inevitable. The natural flow progresses as it does and it was time. President Hoover was replaced with President Roosevelt in 1933. (SearchBeat, 2007) The New Deal of programs to fix the 25% unemployment rate came to a nation of people struggling. (SearchBeat, 2007) Government intervention to support public infrastructure, roads, and bridges gave employment. There were projects to improve power such as the Tennessee Valley Authority. (Davidson, 2008) The Hoover Dam also became a New Deal project though plans had been made for it as the depression began. The work it provided caused migration of men to find work and relocate families where they could be sustained much easier through regular pay.

War was brewing again over the seas, the magnitude of which came to be another world-engulfing event. America became involved when Japan bombed Pearl Harbor in 1941, much to the dismay of the people. Germany had progressed through Europe and was bombing Great Britain. The fall of Britain would have left America open in many ways. Thus using the Pearl Harbor tragedy to gain public support, America entered the war with immense charisma. The destruction of Hiroshima and Nagasaki Japan in 1945, just after the fatal nuclear bombings, brought the end to WWII.

Cold War and Vietnam

The document that laid out the cold war and the psychological profile of the nations as well as their goals for the future was the NSC-68. (Good, 2008) President Truman requested this report. (Whitehouse, 2009) He took a strong stand in several initiatives NATO and the Berlin Crisis being the most memorable. (Davidson, 2008)

Soviet communism was warily watched by those in the American government. The cold war that had began between the Soviet Union and the United States caused policy makers to fear the aggressive nature in which the Soviets behaved towards the Persian Gulf and Eastern Europe. (Davidson, 2008) President Truman implemented policies of communist containment that included: The Truman Doctrine, The Marshal Plan, and another policy called the NSC-68. (Davidson, 2008) Interestingly, the fear of communism’s spread even led to the persecution of American citizens with Senator Joseph McCarthy’s famous speech on February 9th, 1950. He brought forth a list of 57 known communist working in the state department. (Schultz, 1999) This caused an anti-American witch-hunt for communist of a magnitude unseen before.  He endured persecution up until the end of his life seven years later, by varied sectors he had vilified. (Schultz, 1999)

While the government was keeping the American people safe and watching the world, culture, multiple civil rights issues, and the mass of the population was moving in new ways. Automobiles had given freedom and easy personal transportation to the masses. Suburban life was maturing. Women began to find fulfillment out of the house; working and redefining the family. (Davidson, 2008) Black leaders held the public stage with the hopes for a better future. The need for change in areas of civil and human rights became an embattled issue, which changed the scope of history infinitely.

The Vietnam War also found controversial grounds throughout the American soil. The need to understand why it was fought and the overwhelming documentary of it on the mass media brought about a torn nation. The desire to find a better way in conflict with those who in their unreasonableness will always foster war rather than peace is even to the present seen.

America since 1975: The Conclusion

The progression of various movements, government policies, and amendments to the constitution has given America the wonder it is today. There has been various trials and issues through the years and whether dealt with competently or not, it is what it is now and is forever changing as the face of the people and politics reflect the immigration and migration of those long ago on their journey as well as now just beginning the path to live what was once known as the American Dream.  The progression of Presidents from Nixon through Clinton moved the population in thought and economic issues both good and bad. Democracy has its good as well as bad. It can be seen through the course of time, yet the winds of change are with the people as they vote and become active politically. Thus is the beauty of the people who immigrated, migrated and integrated to make America the strong, beautiful place it is today.

References:

  1. The White House, http://www.whitehouse.gov/about/presidents

 

  1. About NSC-68, K. Good 2008) http://wise.fau.edu/~kosgood/coldwar/nsc68

 

 

  1. Davidson, J. W., Gienapp, W. E., et al. (2008). Nation of nations: a narrative history of the American Republic (6th ed., Vol. 2). Boston: McGraw Hill.

 

  1. How Movements Win: Gender Opportunity Structures and U.S. Women’s Suffrage Movements, 1866 to 1919   Holly J. McCammon, Karen E. Campbell, Ellen M. Granberg and Christine Mowery American Sociological Review, Vol. 66, No. 1 (Feb., 2001), pp. 49-70
    (article consists of 22 pages)   Published by: American Sociological Association   Stable URL: http://www.jstor.org/stable/2657393

 

 

  1. Jim Crow Caste System, Dr. David Pilgrim, 2000 Professor of Sociology Ferris State University http://www.ferris.edu/JIMCROW/what.htm
  2. Race Relations in the American West, Richard White American Quarterly, Vol. 38, No. 3 (1986), pp. 396-416 (article consists of 21 pages) Published by: The Johns Hopkins University Press Stable URL: http://www.jstor.org/stable/2712674

 

  1. Symbolic Crusade: Status Politics and the American Temperance Movement 2nd Edition, Joseph R. Gusfield (1986) Illini Books, Chicago IL

 

  1. The Great Depression, SearchBeat (1997-2010) http://history.searchbeat.com/greatdepression.htm

 

  1. The Hoover Dam Construction History, WGBH  PBS (2008) http://www.pbs.org/wgbh/americanexperience/films/hoover/

 

  1. Watching Communism: J. McCarthy, Stanley K. Schultz (1999)                     http://us.history.wisc.edu/hist102/bios/31.html

 

  1. WWI Eye Witness to History, Ibis Communications Inc. (2010) http://www.eyewitnesstohistory.com/index.html