How to Help Raving Mad People

[Dildo Argentino]

Paranoid psychosis is the technical term most often applied to the condition, but you know the type: a person with a complex and intimately interconnected set of beliefs about the world which, to him, look like Troof^TM, as in God's honest, the real deal, everything worth knowing about the world, including what to do about it, while to you, they look like a convoluted, jumbled bag of phantasmagoria with an at bets tenuous, but often totally non-existent connection to the world as it really is.

My dad, for instance. Long story follows.

TLDR: holist's dad is a mad old git. He's been experimenting with being with him in a way that's helpful when he is preoccupied by his paranoid ideation and pretty hyper (i.e. manic episodes) for 30 years or so, with some success, but he would appreciate input.

Dad first went bonkers in 1969, at the age of 30, on the 3rd anniversary of his mother's death. By all accounts she was a truly loving mum and both her sons were deeply shaken by her untimely death. It also happened to be the first anniversary of his firstborn son's birth (that's me!) and his hasty and unpremeditated assumption of the responsibilities of marriage and a child. It was also one year after he, outraged by the events in Czech, publicly renounced his party membership and thereby, in an act of foolish and kitschy, and childish defiance, destroyed the only career he had before him, a promising if unpalatable one at that. His experiences in the holocaust (inclusive of being lost at age 5 in the Budapest ghetto for 5 days in the winter of 1944 and being pulled off a train of displaced children bound for Auswitz at the last minute by an aunt who happened to pass by) also came into it in a big way. I have spent some time and effort reconstructing the events of that fateful night and day. Short version: he ended up nacked, battling demons and attempting to derail a tram by hand in a public square, paranoid to the eyeballs, out of touch with reality. He was sedated and hospitalised for a couple of weeks, and this was repeated every few years while he was still in Hungary, pursuing a line as a member of the "democratic opposition" - a bunch of (old-sense) liberal individuals who got together to scheme a lot and did rather little, but made a big deal out of it, while doing little marginalised intellectual odd-jobs (translation, editing, etc.) to eke out a rather impoverished living.

He left Hungary in 1980. He had had a "western passport" for only a few years then: his making a public fuss about the invasion of Czechoslovakia had cost him that back in '69 - and when the Poles introduced a state of military emergency due to the Solidarity Riots, he got scared that he would be locked inside Hungary again, and, on a whim, bolted to Vienna. His family followed him in a few months, but I did not, though I had been living with him and new wife and kids for 6 years, because at that time I considered him so unreliable I had no doubts about going to live with my mum rather than going with dad along the path of uncertainty that is being a dissident and starting all over in a new place, with an intermittently raving lunatic parent). After a spell in a Vienna refugee camp where he waited for his family to catch up, and a couple of years in Germany, he ended up in Reading, UK, as well-regarded political dissidents were always welcome at the BBC's listening service in Caversham. The Monitoring Service in Caversham was one weird place during the 80's, very Orwellian, Brasilesque: hundreds of people sitting in tiny open-plan cubicles with headphones on, listening to state radio piped in from everywhere around the world, using antiquated recording devices that actually recorded audio magnetically on metal wire and were foot-switch operated (!!), and then using typewriters to type out summaries or, in the case of more important broadcasts, verbatim English translations for British intelligence.

He was in pretty good nick when he arrived. The reason he flipped his lid again was that he had expected a bit of a hero's welcome, and got a truly shoddy deal instead. The job was terrible. 12-hour and 16-hour shifts, ugly, uncomfy headphones on all the time, irregular sleeping hours and hard, hard work for not very much: I think his fate was sealed when he unadvisedly let on that he was good at Russian, too. He was, but not quite native-language good: he could do the same work in the Russian section, where he was frequently placed to fill in, but it was four times more arduous and didn't pay more. He started missing shifts, then acting strange, sleeping on the job, summarising an important speech by Kádár when he should have translated it verbatim: the British bureucracy swung into action (it's funny that the Monitoring Service was actually a part of the BBC), and they fired him in a cold and cruel fashion, I have the correspondence to prove it.

Thus began a career as the scary foreign lunatic in a parochial county town not, at the time, known for its understanding of outsiders, especially mad ones that struggled to keep their clothes on when things went wrong and who could escalate with the best of them.
Through an amazing plethora of any-and-all jobs, he struggled to keep providing for his family for years as barman, night petrol station attendant, hotel cleaner, deafness-awareness raiser, delivery man, milkman, advertising leaflet distributor, paperboy, car-park attendant, cook... and every now and then, when he couldn't handle the stress, he threw a wobbly, ended up sedated and in a warm place with soup. Kinda worked for him. The first few times, he fought like mad for his rights, even acquired a loyal solicitor who believed in him to an extent of taking him on pro bono for years, later on he just accepted that this happened occasionally and learnt to be let out as soon as possible through docility and eager rule-following.

I arrived in Reading six years after him, in 1986, and for years I tried to do the right thing and failed in several ways. My initial fear (he was right scary when he was up to his antics when I was a kid) flipped to anger and the realisation that I am now stronger than he is in every way, and eventually I found that if I have the time and the inclination to be with him 24/7 when he is raving, I can largely steer him out of trouble gently. But he's old and broken now, and doesn't seem to do it anymore... which, in a horrormirthy way, is kinda sad. I'd like to have a go at it with him one last time, to see if I could last the course through a fully fledged psychotic episode. In a childhood totally devoid of role models (and filled with various flavors of broken alcoholics and emotional cul-de-sacs), he was the closest thing. He was mad, at times disgusting, at times truly scary (as manic people skirting the border of psychosis can be), at times unbelievably sad, but he never sold out. Taking on 6 police in riot gear and giving them a run for their money... way to go, dad. Now he's mellowed into an incontinent and fadey old dwarf who spends his time in the valley of the darkness of death, with regular sparkles of surprising wisdom. Took me a long time, but I do appreciate him now. My holocaust syndrome could have been a lot worse, had he acted some other, more conformist way.

At his most sane, holist Snr could present a better-than-passable impression of being a terribly urbane man with both a twinkle and a good humoured insight of what it was to be human. Today, he is certainly not urbane (a fucked up old weirdo is more like it), but the twinkle and the insight has matured and can be elicited on good days. However, at his least, he was everything you don't want from the mad foreigner down the road who will not go away and has seen right through the worst that can be done to him to try to make him different.

The institution that played a sizeable part in destroying his life (for it is largely a train-wreck with a few silver linings, mostly in the shape of offspring who are all faring reasonably) was not a mental one: it was just the system of Communism-Socialism that operated in Eastern Europe from 1946 until the "Change of Regime" in the 1990's. He could have been smarter, a select few have, but I can't really bring myself to blame him for failing... he gave it all he had, which was not all that much, and came out less than a winner. Bless him.

***

Of course, with dad being the way he is, the maniacs and the delusionals have found me regularly ever since. I think I tolerate that flavour of madness much better than most anyone I know (and the exceptions are nutters themselves! and so am I), but the best approach is to treat them as an unreliable, fucked-up child: hang around, show some interest gently, be available, prevent minor and major disasters as they turn up. What do you think?

[Mesozoic Mister Nigel]

I'm sorry your father is mentally ill; that's a tough burden for any child, even an adult one.

If you feel that it's part of your calling to shepherd the mentally ill, more power to you. Your approach seems pretty sensible, though it runs the risk of becoming enabling and/or codependent. As long as you're aware and comfortable with it, and are conscious of the possibility of developing a martyr or messiah complex yourself, I'd say roll with it.

On the other hand, a lot of people with severe mental illnesses are quite treatable, and might not need a shepherd if they had access to (and could stay on) the right medication.

[Mesozoic Mister Nigel]

If you do find yourself dealing often with people who have severe mental illnesses such as paranoid schizophrenia or bipolar disorder, there are often, depending on where you live, educational opportunities for people who are close to someone struggling with those issues in loved ones.

http://www.nami.org/Content/ContentGroups/Helpline1/Coping_Tips_for_Siblings_and_Adult_Children_of_Persons_with_Mental_Illness.htm

[Dildo Argentino]

I'm sorry your father is mentally ill; that's a tough burden for any child, even an adult one.

Thanks for the commiseration. Actually, it took me a good 35 years, but it doesn't bother me any more. Except for the fact that if he had competent help available at the outset, he could probably have avoided the pattern. And the fact that he's used up his body a lot and is unlikely to be lively ever again, I do regret that. I would probably pay money to participate in a manic episode now. The old (and mad) lion has lost his teeth.

If you feel that it's part of your calling to shepherd the mentally ill, more power to you. Your approach seems pretty sensible, though it runs the risk of becoming enabling and/or codependent. As long as you're aware and comfortable with it, and are conscious of the possibility of developing a martyr or messiah complex yourself, I'd say roll with it.

I did the martyr bit when I was six: my mother finally worked up the courage to divorce him, and he talked me into staying with him (my sister, and only sibling) stayed with my mum. It was a bloody stupid thing to do (I mean for my parents) and it kept me in a bind for a very long time before I realised that that was all it was: two loving and rather incompetent parents fucking up.

I did the messiah thing much later, I rescued him from a hospital where he was being ridiculously oversedated and preparing to die (he had successfully sued the mental hospital the previous time: they took their revenge next time they got their hands on him), nursed him back to a semblance of health, then he fucked off again, as he does: it usually begins to begin when something mightily important comes up. I think I'm safe now, though I am about to change track from translator to art therapist. But I actually want to work with less severe cases, at least mostly.

On the other hand, a lot of people with severe mental illnesses are quite treatable, and might not need a shepherd if they had access to (and could stay on) the right medication.

I'm not so sure about that. I'm all R. D. Laing, Wilhelm Reich, Thomas Szasz and Sue Gerhardt, not to mention probably quite Michel Foucault about the whole conceptual minefield that surrounds mental health/illness and the ways society deals with it. While there are clearly simple and organic reasons for going mad, and very probably very complex and organic reasons for it as well, I think most people diagnosed with severe mental illness (psychosis, bipolar, monopolar depression, OCD, I could go on) are driven nuts by the society they live in, and while the drugs may help to manage the symptoms (often largely for the benefit of those around the mad person, although I've met more than a few self-confessed happy poppers, too), they could not rightly be called a cure. Which types of severe mental illness did you have in mind?

[Mesozoic Mister Nigel]

I was thinking particularly of the two I've mentioned previously, bipolar disorder and schizophrenia. Both are quite responsive to drug treatment.

While "driven mad by society" certainly is romantic, I doubt it's true on a deeper level, as mental illness appears in every society and has been recorded across history. I would agree that our current modern Western society deals with it poorly and almost certainly exacerbates some forms, while generally excusing/failing to recognize others, even forms that would have resulted in banishment in other cultures and times.

It is likely true that with a compassionate and supportive environment, your father probably would have had a different outcome. It is also likely true that his illness played a major role in the unfortunate treatment he received, which generates a feedback loop. The situation was not created 100% by either game nor player.

[Doktor Howl]

While "driven mad by society" certainly is romantic, I doubt it's true on a deeper level, as mental illness appears in every society and has been recorded across history.

This is true...But it is also true that, while individual stressors may be less intense than they were in, say, 1600s Germany, people have a far greater NUMBER of stressors than they have in the past, and that trend is likely to continue.  "Future shock", as it was first called in the 1970s, causes all manner of mental issues.  However - and I am no expert on this - I don't think outright psychosis is one of them.

It would be interesting to find out if there's a link between prenatal stress on the mother's part, with the alleged rise in autism-type disorders.

[Mesozoic Mister Nigel]

While "driven mad by society" certainly is romantic, I doubt it's true on a deeper level, as mental illness appears in every society and has been recorded across history.

This is true...But it is also true that, while individual stressors may be less intense than they were in, say, 1600s Germany, people have a far greater NUMBER of stressors than they have in the past, and that trend is likely to continue.  "Future shock", as it was first called in the 1970s, causes all manner of mental issues.  However - and I am no expert on this - I don't think outright psychosis is one of them.

It would be interesting to find out if there's a link between prenatal stress on the mother's part, with the alleged rise in autism-type disorders.

Not autism, at least as far as research shows so far. Anxiety disorders, yes.

Do you have some kind of citation for the "greater number of stressors"? I find it a little challenging to swallow, given what life was like in pre-industrial Europe. How are you quantifying stressors?

[Mesozoic Mister Nigel]

I also think it's worth mentioning that having studied the history of the treatment of mental illness in Western society, the way the mentally ill were treated in 17th-century Europe was absolutely horrifying. I'm a little concerned that there's some romanticizing of the past going on here. There was very little compassion and the mentally ill were treated largely as brutes and animals, although at least social views were undergoing a shift away from exorcism or simply stoning them to death.

[Doktor Howl]

While "driven mad by society" certainly is romantic, I doubt it's true on a deeper level, as mental illness appears in every society and has been recorded across history.

This is true...But it is also true that, while individual stressors may be less intense than they were in, say, 1600s Germany, people have a far greater NUMBER of stressors than they have in the past, and that trend is likely to continue.  "Future shock", as it was first called in the 1970s, causes all manner of mental issues.  However - and I am no expert on this - I don't think outright psychosis is one of them.

It would be interesting to find out if there's a link between prenatal stress on the mother's part, with the alleged rise in autism-type disorders.

Not autism, at least as far as research shows so far. Anxiety disorders, yes.

Do you have some kind of citation for the "greater number of stressors"? I find it a little challenging to swallow, given what life was like in pre-industrial Europe. How are you quantifying stressors?

Nope.  No citation.  I am definitely talking out of my ass, here, and am operating on memories of books I have read on the subject.  That being said:

In pre-industrial Europe, you basically had about 7 daily stressors:

1.  Rampaging armies of Tercios killing you.
2.  Sectarian mobs killing you/witch hunts/inquisition.
3.  Starvation (during the 30 years war, 25% of Germany died, about 80% of whom died from disease or starvation).
4.  Plague, smallpox, diptheria.
5.  Making enough money to get married.
6.  Worst infant mortality rate prior to the Ethiopian famine.
7.  Pissing off the local lords (many of whose interests overlapped), who then kill you.

Right now, we don't have anything on that order, but what we DO have is a massive, non-stop bombardment of signal, with advertising designed specifically to create additional sources of stress (which can, of course, be remedied with the product being sold).  Oddly enough, the removal of the cold-war armageddon scenario seems to have INCREASED the stress level.  It would be interesting to determine if stress caused by life-threatening events is more easily dealt with than information overload.  After all, human brains evolved to deal with threats to life and limb (ie, leopards, competing tribes), but not a 24/7 stream of information, most of which involve vague, scarcely-definable fears.

[Doktor Howl]

I also think it's worth mentioning that having studied the history of the treatment of mental illness in Western society, the way the mentally ill were treated in 17th-century Europe was absolutely horrifying. I'm a little concerned that there's some romanticizing of the past going on here. There was very little compassion and the mentally ill were treated largely as brutes and animals, although at least social views were undergoing a shift away from exorcism or simply stoning them to death.

Hell, you don't even have to go that far back.  Just go back to the 1980s.

[Mesozoic Mister Nigel]

Some literature on prenatal stress:

https://francais.mcgill.ca/files/projetverglas/Prenatal_Stress_and_Brain_Development.pdf
https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&cad=rja&uact=8&ved=0CC8QFjAC&url=http%3A%2F%2Fdevelopingchild.harvard.edu%2Findex.php%2Fdownload_file%2F-%2Fview%2F469%2F&ei=HbFXVL37G4OZjAKG2oGIAQ&usg=AFQjCNHhjIPW7ohQEDZMX99YgNr2lTMjKA&sig2=0nIUBku2rh7w0mJJACsexg&bvm=bv.78677474,d.cGE

[Doktor Howl]

Some literature on prenatal stress:

https://francais.mcgill.ca/files/projetverglas/Prenatal_Stress_and_Brain_Development.pdf
https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&cad=rja&uact=8&ved=0CC8QFjAC&url=http%3A%2F%2Fdevelopingchild.harvard.edu%2Findex.php%2Fdownload_file%2F-%2Fview%2F469%2F&ei=HbFXVL37G4OZjAKG2oGIAQ&usg=AFQjCNHhjIPW7ohQEDZMX99YgNr2lTMjKA&sig2=0nIUBku2rh7w0mJJACsexg&bvm=bv.78677474,d.cGE

Woot!  Thanks.

*off to read*

[Doktor Howl]

From the first link:

In humans, prenatal stress (PS) is linked to an increased
vulnerability for developing various psychosocial problems
that are observed both in childhood and adulthood. In children,
PS is associated with cognitive, behavioral, physical and
emotional problems (King and Laplante, 2005; King et al., 2009;
Laplante et al., 2004, 2008; Talge et al., 2007) as well as with
autism

Ain't life grand when a wild-ass guess turns out to be possibly accurate? 

(reading more now)

[Doktor Howl]

Cortisol...The Paesors strike again!

On a serious note, I am seeing more and more references to cortisol.  This bothers me, because it implies that my rage (as well as every other emotion I feel) may actually just be a series of chemical reactions.  I don't like that.  Doesn't mean it ain't true, just means I don't like that.

[Mesozoic Mister Nigel]

While "driven mad by society" certainly is romantic, I doubt it's true on a deeper level, as mental illness appears in every society and has been recorded across history.

This is true...But it is also true that, while individual stressors may be less intense than they were in, say, 1600s Germany, people have a far greater NUMBER of stressors than they have in the past, and that trend is likely to continue.  "Future shock", as it was first called in the 1970s, causes all manner of mental issues.  However - and I am no expert on this - I don't think outright psychosis is one of them.

It would be interesting to find out if there's a link between prenatal stress on the mother's part, with the alleged rise in autism-type disorders.

Not autism, at least as far as research shows so far. Anxiety disorders, yes.

Do you have some kind of citation for the "greater number of stressors"? I find it a little challenging to swallow, given what life was like in pre-industrial Europe. How are you quantifying stressors?

Nope.  No citation.  I am definitely talking out of my ass, here, and am operating on memories of books I have read on the subject.  That being said:

In pre-industrial Europe, you basically had about 7 daily stressors:

1.  Rampaging armies of Tercios killing you.
2.  Sectarian mobs killing you/witch hunts/inquisition.
3.  Starvation (during the 30 years war, 25% of Germany died, about 80% of whom died from disease or starvation).
4.  Plague, smallpox, diptheria.
5.  Making enough money to get married.
6.  Worst infant mortality rate prior to the Ethiopian famine.
7.  Pissing off the local lords (many of whose interests overlapped), who then kill you.

Right now, we don't have anything on that order, but what we DO have is a massive, non-stop bombardment of signal, with advertising designed specifically to create additional sources of stress (which can, of course, be remedied with the product being sold).  Oddly enough, the removal of the cold-war armageddon scenario seems to have INCREASED the stress level.  It would be interesting to determine if stress caused by life-threatening events is more easily dealt with than information overload.  After all, human brains evolved to deal with threats to life and limb (ie, leopards, competing tribes), but not a 24/7 stream of information, most of which involve vague, scarcely-definable fears.

I think it would be very difficult to say that there are "more" stressors, because you could also, using your logic, either split all of the internal components of each pre-industrial stressor and count them individually, or you could lump all of the modern stressors you just mentioned into one category, "media". So I think that's a spurious argument with poorly-defined boundaries, and literally nothing to support it.

So lets look at your claim that the end of the Cold War resulted in more stress. Can you support that? What I've read indicates that the opposite is true, except in adults who were raised with the constant fear of nuclear war. The fear remains even after the threat is removed; that's the hallmark of chronic stress.

There is lots and lots of research on stress, how we respond to stress, and how it affects the body. It's true that the immediate threat of attack and death, that is resolved by escape, is handled by the body far better than the stress of, for example, a shitty but not-immediately-threatening work environment, or poverty, or being the target of racism.

But you're still going to be hard-pressed to convince me that overall, blacks or women or the poor are more stressed now than they were in pre-industrial times.