| Introduction
In 1994, Anne told me that she
was admitted to a mental hospital as a school girl.
She was often medicated with a major psychotropic
drug, Mellaril, and was also administered Electroconvulsive
Therapy. This affected her memory and her education.
She became a chronic psychiatric casualty who is
still chemically dependent today. Her sister was
placed in a Welfare institution and was subjected
to harsh treatment from big girls of a different
sexual orientation. Anne was raped in the mental
hospital while her sister was bashed in the Welfare
institution.
Many people have lived a life of
chronic disadvantage arising from the system taking
over and breaking families irreparably. In the fifties,
sixties and seventies there was not much knowledge
of the consequences and deep injuries done to members
of dysfunctional families. Families that were cut
adrift by the system had children and adolescents
sent to foster homes, institutions or to mental
hospitals. Sexual abuse occurred, probably frequently.
One former female foster child told me in 1994 that
she had been sexually abused in foster care. Two
men, Adrian and Peter recently told me they had
similar experiences in foster care.
Members of dysfunctional families
have always been of interest to Welfare and Psychiatry.
What is becoming apparent is that many of their
issues are social problems that create burdens on
the taxpayer, benefit dependency, and much ill health
in the face of health fund cuts. Health cuts now
ensure that only clearly diagnosed people and substance
abusers are treated or hospitalized. The social
problems now have to be worked out with people who
are not interested, and often not knowledgeable
about the issues. One way to address social and
family dysfunction is through education - self-education
for survivors and also for the professional people
who assist survivors.
Some survivors, for example, may
experience repeated abuse, isolation and witness
threatening and intimidating behavior of others.
Oftentimes, other family members' inappropriate
behavior or reactions (e.g., they blame the survivor
for the abuse) heightens traumatic reactions. The
survivor may (if they are lucky) be referred for
professional help. The casualties of families like
this have been described in submissions to the 1996
Mental Health Inquiry. In the meantime, with limited
resources, some psychiatric and/or mental health
professionals will send the victims away and say
"Go back to your family." There may be
no family to return to! This is a social problem
and there are too many casualties in New Zealand
with issues still not properly resolved.
In the early 1990s, I addressed
Social Workers of the Children and Young Persons
Service. I told them that I often speculated over
whether or not some foster children were being abused
by their foster parents. A Social Worker gave me
vigorous nods from a back seat. Children of abusive
parents may be affected by family dysfunction from
the extended family that became their foster family.
As adults, they are prone to becoming ill and have
more brushes with "the system." In many
cases their sense of self worth may be severely
knocked, and there are few reliable supportive people
in their environment.
Every survivor has good attributes
and qualities. They may have tremendous potential
but in difficult financial times, survivors often
do not have the money to develop that potential.
An adjunct Professor in Colorado, Dr. Warner wrote
that survivors of Schizophrenia could recover in
prosperous times. The same is true of every other
survivor in New Zealand.
In 1994, a Social Worker with Children
and Young Persons Service suggested to me that long-term
consequences of family dysfunction were not the
problem of their department. An Income
Support person told me both branches kept on "passing
the buck." In 1995, I suggested to policy makers
that they bring parents into the campaign on prevention
of child abuse. The reply was that it "all
depended upon the allocation of resources."
In 1998, the Children and Young
Persons Service are now pushing to collaborate with
Health personnel. Public Health and the Children
and Young Persons Service in New Zealand are affected
by funding cuts. So problems of dysfunction affect
family members responsible for people who have gone
through the system. Other victims are left to their
own devices, often in conditions of chronic disadvantage
and extreme poverty.
Posttraumatic Stress
Disorder
More knowledge has emerged since
the eighties in keeping with the policy of emptying
the mental hospitals; it was then that Posttraumatic
Stress Disorder (PTSD) entered the diagnostic manual.
This is a useful way to understand the effects described
above. A significant and deleterious aspect of PTSD
is the train of thoughts associated with the violence
experienced by survivors at the hands of abusive
or hostile people. The traumatic thoughts may haunt
the sufferers for two decades or more. The thoughts
can also be accompanied by vivid pictures behind
the eyes of violent or vicious people. These pictures
are called "flashbacks." Some sufferers
never lose their traumatic thoughts or the flashbacks.
Pharmacology may aid in diminishing certain symptoms,
but there is still sound evidence that mental health
professionals often make serious diagnostic errors
regarding PTSD. Survivors of PTSD may be misdiagnosed
as Borderline Personality Disorder and may be pressured
to change their behavior.
Some survivors, unable to stop
the flashbacks, may create different pictures. Some
may become sufficiently empowered to understand
that flashbacks are a symptom of Posttraumatic Stress
Disorder and effectively reduce or stop them all
together. Toxic psychiatry or ill-prescribed drugs
may exacerbate trauma reactions and at times, contribute
toward the experience of flashbacks.
Flashbacks can cause terror and
horror for survivors. It is comparable with (and
often confused with) the hallucinations of Schizophrenia.
Many women affected by PTSD died at the hands of
their violent spouses before laws changed in the
United States. Aphrodite Matsakis, Ph.D. a specialist
in PTSD wrote about "Claudia" in Chapter
Four of her book I Can't Get Over It. Claudia
was a battered wife to whom the police said "There's
nothing we can do about it. Call us after he actually
starts beating or cutting you." In the United
States in the 1960s, a wife needed consistent hospital
reports for seven years before she could win divorce
on "battered wife" grounds and a fair
settlement. Claudia did not win her divorce, her
spouse did. Evidence was given at the court that
she had several (unspecified) psychiatric disorders.
She was blamed for breaking up a happy home. Her
spouse won the home and left her in poverty. His
victory gave him authority to tell Claudia that
he would get the children if she could not support
them. Dr. Matsakis wondered whether Claudia's legal
counsel was incompetent, or whether there were darker
reasons that the personality of the abusive spouse
was not brought up in the divorce proceedings.
Dr. Matsakis writes that professionals
including doctors and nurses, at times, minimize
grievous losses. For example, after a Hurricane,
a concert violinist was taken to a makeshift hospital
along with others who were injured. When she was
told that three of her fingers would have to be
amputated, she began to cry. Her nurse told her
"Hush now, you big crybaby, bed number one
lost his arm and bed two has to have both legs removed.
Count your blessings and don't upset the others."
It is this sort of indifference that must stop.
If more people including professionals hear the
cries, I believe that many of the tragedies (and
potentially, revictimization) could be stopped by
a change in direction from the policy makers.
Emotional Disorders
and Denial
New Zealand has been in denial
of the realities of social disadvantage for many
years. The denial is possibly an artifact of people
being frightened by what they can not face in themselves.
Victims of social casualties, injustices, and massive
losses are prevalent in New Zealand society and
survivors can and will not go away.
One abused woman was told by her
divorced spouse that she could "crawl off the
face off the earth." This is indicative of
the way many people regard abused people, who need
to be heard and be assured that the injustices will
be addressed. If society, social policy makers and
the lawmakers do listen, the pain may be slightly
alleviated. Unfortunately, many adhere to a "Just
World" philosophy (see the work of Janoff-Bulman).
The basic assumption of the "Just World"
philosophy is that if you are sufficiently careful,
intelligent, moral, or competent, you can avoid
misfortune.
A Case Example from
Aotearoa, New Zealand
New Moon, a newsletter
put out by the Aotearoa Network of Psychiatric Survivors,
published an account in 1992 of a woman, "Raelene,"
not being dealt with appropriately or compassionately
after she was raped by an Island man in a mental
hospital. She was later cruelly manhandled by nurses
when she spoke about the rape at a group meeting.
The hospital people told the family an alleged incident
occurred. I met Raelene in 1994. She was repeatedly
committed through the testimony of a nurse solely
concerned with the behavior and the symptoms. Raelene
was trying to restore the lost mobility of her left
side. She had to have several smaller meals in the
course of a day because of her stomach condition.
Her stomach bled from the drugs she was made to
take and the last time I saw her, she looked very
ill indeed.
Deinstitutionalization:
Human Rights or Financially Driven?
A few years ago, a nurse asked
me what I thought was the driving force behind the
emptying of the mental hospitals. I believe that
the policy is driven monetarily. Dr. Jenkins,
a United Kingdom doctor, attended the 1993 mental
health conference in Auckland. He suggested that
the proceeds from the sales of hospitals should
be put back into providing services. This would
ensure that deinstitutionalization would be successful.
Unfortunately, proceeds of the sales of hospitals
do not appear to have been injected into community
services.
Conclusion
Although more care with psychiatric
and abuse survivors is often taken today, not all
cases are successfully helped. My research and experience
in the first half of this decade appears to be about
abused rather than mentally ill people,
per se. Survivors' family status is not always addressed
by support workers, although family status in the
Human Rights legislation must be adhered to. The
Human Rights Act covers situations such as employment,
provision of services, and accommodations on the
grounds of age, sexual status, health and family
status.
Survivors are often held accountable
for the wrongdoing in their family. We must remember
that the problems of sexual abuse in children, adolescents
and adults as well as the abuse sustained by the
members of dysfunctional families are very serious.
Theses difficulties are quite prevalent. The issues
often appear to be swept under the carpet. Sadly,
misdiagnosed survivors are often ridiculed or stigmatized
by many people which perpetuates their social disadvantage.
©1998 by The
American Academy of Experts in Traumatic Stress,
Inc. |
