Thursday, January 13, 2011

Jared Loughner and me . . .

I just read a long, front page piece in The Washington Post, about Jared Loughner, who'd evidently been quite desperately ill for some time. And please note that I say he was "ill," not "mentally ill," because to me part of the responsibility for the Arizona shootings comes from society's (meaning yours and mine) habit of differentiating between mental and physical illness. We've already established that separation did not lead to equality in schooling. Nor, I would submit does it lead to equality in our treatment of the sick.

Isn't it time we recognize that, to paraphrase Gertrude Stein, an illness is an illness? That behavior is as legitimate a symptom of a need for medical intervention as a temperature or a seizure? That those of us who would reach out to anyone who faints, should reach out anyone who acts as Jared Lougher has for years?

Photo of Loughner playing the saxophone as a teenager in a jazz program.
Photo courtesy of Robert Blanco Photography
The Washington Post article about Mr. Loughner paints a portrait of a musically gifted kid who had some kind of a break in high school, for which he was never treated, and from which he never recovered. Instead his illness got worse, as untreated illnesses do, and we all know what happened.

Two thirds of the way through The Washington Post article, researched and written by three Post staff writers, was this:
In the past year or so, the crumbling of what was once Loughner was clear to anyone who bothered to look. Teachers, fellow students, even the anonymous e-buddies who substituted for the real friends he had lost - many suspected mental illness and said so, to one another, to Loughner, even to people who might have taken action. But no one did.
Later on in the article comes ...
By last summer, evidence of Loughner's increasingly deteriorating mental state was littered across the electronic worlds he inhabited.
On one site, Above Top Secret, Loughner left dozens of posts with bizarre theories about U.S. currency, the Constitution and grammar. Finally, another regular on the site wrote back that "I think you're frankly schizophrenic, and no that's not an amateur opinion and not intended as an uninformed or insulting remark. I really do care. Seek help before you hurt yourself or others or start taking your medications again, please."
Loughner, known on the site as "erad3," responded, "Thank you for the concern." 
There's already been a lot written about how inadequately we, as a  society, deal with mental health. Here's an excerpt from George Kubin's OpEd in Wednesday's Chicago Tribune.
... As a nation, we fail over and over to address the problem of mental illness and then wonder where these people come from when there is a mass murder. These people do not see the world like most rational people. Applying a rational form of justice on an irrational individual does nothing to address the core problem. Rather than viewing these events as isolated incidents, we as a society need to do a better job of educating people about what options there are to get people with mental illness the help they need.
Sure. Sure. I agree with Mr. Kubin completely. But, to me, the language of this piece still somehow separates the mentally ill from the physically ill, as though "these people" were somehow something other than "people."

This issue is personal with me, as I am chronically ill with both the disease of addiction and the disease of depression. Both -- hallelujah -- are in deep remission through treatment, but I am still ill. If I hadn't gotten treatment, who knows what I'd be doing this fine bright morning instead of blogging away for WMRA!

Treating the mentally ill begins with accepting -- and I mean accepting -- that "mental" illness is no more of a stigma per se than any other illness; say, for example, diabetes. Both are conditions that threaten a person's ability to lead a healthy life as a fully functioning member of society. Both need medical intervention. We've got to stop separating how we, as individuals and as a society, view the two.

This post is a plea to examine your own attitude toward the "mentally" ill. If you think of  Jared Loughner as "an other," then think of me as "an other" as well. Conceivably, the difference in what we did with our lives could be attributed, at least partially, to the difference in the help we got.


  1. Thank you for a post filled with honesty and clarity.

  2. I think the difference is not the help one gets as much as the help one is willing to accept. With some exceptions, those with "physical" illnesses recognize they have an illness or disability and attempt, one way or another, to remedy it, and even when they don't there are rarely serious effects on strangers.

    I don't pretend to diagnose Jared Loughner and don't know his history. I do have a paranoid schizophrenic client who refuses to recognize her illness, even though it may kill her. Without that recognition she will never accept treatment. Fortunately, she is not likely to be violent towards anyone. OTOH, an associate pastor at the church we attend is bipolar, well-controlled by medication. He operates normally - in fact I didn't know he had that problem until he mentioned it after we had known him for at least a year. To me and the others around him he is no different from a diabetic who controls his disease.

  3. Hey Jim -- don't you think if we were a bit more accepting of "mental" illness as just another illness, it might be easier for someone to accept treatment? Not that I know your client, at all. I just know how surprised people are when I blat out that I'm both a depressive and an alcoholic/addict. I always assume it's because I don't fit their image of what someone with mental illness should look like. That make sense? Cheers, M

  4. Perhaps the acceptance of treatment by the affected individual depends on personality. If self-righteousness is on-board, the person will not seek or accept treatment. In the case of a teenager, the court often will not intervene because there this a "gray" age between being a child and an adult. If a person does accept treatment, it requires that individual to stay with the program; often times they stray from it. I hail the success of those who have sought treatment and are in control of their illness.

  5. Do you think people treat you differently after you disclose? I would be surprised if they did. I think you can make your case for untreated alcoholism/drug addition or depression because there's a large part of the public who thinks those afflicted should simply quit booze/drugs or just snap out of it. There is a stigma there.

    But I think my client (and Loughner, if some of the reports about his ramblings are accurate) isn't affected at all by social stigma. She is completely internalized, dealing only with the warped reality in her mind. She denies treatment not because she is at all worried about what others may think of her, she refuses because she thinks she's perfectly sane.

  6. I just got back from doing a story at Western State Hospital, a long-term, state run treatment facility the staff describes as the last resort of those with severe mental illness -- mostly psychosis. One of the big challenges of psychosis is that, left untreated, it appears to wreak increasing havoc on the brain, meaning that getting people treatment immediately after a psychotic break is essential. It does seem to me that if we, as a society, were easier talking about severe mental illness -- i.e. easier recognizing it as a severe ILLNESS, we might be more successful in getting people to get help while they were still helpable.THIS make any sense?

  7. Martha, I agree that there is definitely a stigma around having an illness of any sort, even the more common alcoholism and depression. I also agree with Jim that - regardless of the amount of offered help - should the ill be in denial of their illness, treatment will never succeed. We'd like to think that we would treat everyone equally, regardless of circumstance; however, even the patients know that, though perhaps innocently and subconsciously, there's a stigma.

    One of my friends was showing signs of depression and desire to leave our area for a "job" in Colorado (his lie to put us at ease for awhile once he was gone). I told our mutual friends, nonchalantly and almost apologetically, that it "kind of sounds like he's going to commit suicide." Our mutual friends, who all knew him better and longer than I did, said he was a happy guy and would never do that. He attempted suicide about a week later.

    He was admitted to the "mental illness" part of the hospital and, within a week, had convinced the doctors, his prescribed therapist and all of our mutual friends - again - that he would be fine. I was the only person who said I didn't believe him, which he privately told me afterward he was thankful for. Our friends said they were trying to be optimistic for him, to show him that they supported him. But they didn't help him. They didn't listen to what he needed. They thought treating him equally was the best and easiest answer, when really, our friend was humiliated that his attempt to kill himself failed, and now all of his best friends were skirting around it like they don't know him at all. He was in denial of his illness, and so were his friends.

    So, from a doctor's point of view and a patient's point of view...should we recognize the stigma, accept the illness and fight with the ill through their denial? Or do we respect their saying, "I'll be fine," and leave them be - like they're just any other person?

  8. I surely do not know -- but I do think that how to deal with ourselves and other struggling with such illnesses are discussions we should be having openly.

    My hope is also that if those of us who've gotten treatment are open that we've needed it, it will encourage anyone who's in denial to feel it's worthwhile to reach out for help. We are as sick as our secrets, and when our secrets include a sickness, we're in deep, deep trouble.

    I'm not a romantic about this. Someone such as Jim's client has probably been in and out of psychosis for a long time may perhaps be past meaningful intervention. The chances for a schizophrenic's leading a productive life ratchet up the sooner the disease is diagnosed and treatment begun.

    I also think it's a mistake to reinforce someone's denial of their illness by being "polite." A person who's ill and needs help, is ill and needs help; and the first step is a kind, compassionate and united message that this is so from the rest of us.

    THIS make sense. What a GREAT discussion, by the way!

  9. I think there are two origins to the separation of "mental" vs "physical" illness.

    One is that we naturally separate the mind from the body. It is a mind-boggling paradox that "I" can change "my" thoughts. Who is the "I" except my thoughts?

    The other is our only very recent knowledge of how to treat psychiatric disorders. We routinely ream out arteries inside the heart by sticking a tube in the groin and watching through a magical x-ray camera, but for the brain we have a few pills and a lot of talk and hope.

    I believe as we get better at treating "mental" illness, the stigma will continue to fade; I have seen significant progress in my life-time. (Not enough, mind you...)

    Unfortunately, there will always be a gray area between illness and taking responsibility for ones behavior. Do we blame the addict who kills someone while driving drunk? Yes. Do we blame the guy who eats hamburgers and has a heart attack while driving and kills someone? No. Do we blame the psychotic schizophrenic for an act of violence? Sometimes...

    And then there is the question of social safety. We don't know how to treat those young boys who like to hurt animals and grow into violent weirdos. They are ill, but till we have a cure we need to lock them up, or lobotomize them, or something...

    Which runs rather to the edges of the arguments, and does not contradict Martha's good and basic point -- learning about and recognizing "mental" illness as being in the same category as diabetes is an important step in our evolution as a society. IMHO.

  10. The mercy to the guilty is cruelty to the innocent.
    Have you read Jared's online posts?
    I have. He sure doesn't sound crazy in them. It seems more like he wanted attention, he talked in one about how cool it would be to have a US coin have his face. Attention Whore.
    There also some very interesting posts about racism that support the tea party's view on the matter. I think this is more of a wake up call for politicians, about growing hate in people for the benefit of their political campaigns. I don't think we should feel empathy for someone like Jared Loghner, for the sake of the victims.