Photos of Vermont Cottage, and of the Artist, Herself

I thought I would post a few pictures of where I have been living these past few weeks, both how it was this past summer and what it looks like now. And me, too. Since most of you likely have no idea what I look like unless you have read DIVIDED MINDS and of course those photos, the most recent in them, was the author photo taken some ten years ago in 2004.

Carriage House Kitchen area summer 2014
Carriage House Kitchen area summer 2014

summer 2014

Dining/arts area of carriage house Summer 2014
Dining/arts area of carriage house Summer 2014

The above photo is the cottage kitchen area and dining/arts area as they were this summer, before I brought all my stuff up here. It was much less cluttered then and lighter! Below photo is the dining and “arts” area where Lydia and I did our artwork and where most of Dr Geuss was made…

The next photo is from the summer, me holding the brown paper beginnings of Dr Geuss (actually this was when Lucy Goosey was rather far along…(trust me! ) Nevertheless if you look hard enough you will see that I am just holding the wings on — I have not yet figured out how to secure them.

Pam with Lucy Goose  (Dr Geuss-to-be)
Pam with Lucy Goose (Dr Geuss-to-be)

As it turned out what I decided to do was to drill a hole through each wing, after Lydia and I painted them, a hole right through a painted dot, then a hole into the body (I think we decided to drill maybe three holes per side about a quarter inch in diameter. ) I sawed chopsticks from supper the night before into little dowel pieces maybe 2 inches long, then I pushed the chopstick dowels into these holes, along with glue, thereby attaching the wings permanently to the body. I thought it was a rather ingenious if not elegant solution to the problem, especially as glue and papier mache solution itself was not going to hold them in the position I wanted.

The only other way I had solved this sort of problem before had been in the out-held arm of Dr John Jumoke. Then I just “smooshed” and actually used Plaster of Paris, which I would not do again. Gypsum (P of P) would just have added weight to the held out wings of the goose, which would not have been good, nor for a sculpture that by its very nature needed to be easy to move.

Anyhow when I was done, I was very pleased when I offered it, through Cyndi my therapist to the Human Services Department in Vermont’s Northeast Kingdom (St Johnsbury) and they were nice enough to accept it.

This was not a given. Hartford’s Children’s Hospital had refused two sculptures on the pretext that they were a “fire hazard” even though for the two days they were on display there apparently they were wildly popular.

Pam with Dr Geuss in NEK Human Services Dept -- Children's Area

Well to finish out this saga, the photo of me with Dr GEuss above is in the children’s department where it started out, but apparently the kids wanted to “ride” it so instead my therapist there who is artistic herself made a lovely table for it, and they put it out in the front reception area for everyone to see. I was thrilled to see this when I came back and first arrived there for an appointment from The Care Bed.

Mt Harmony Farm Carriage House 2014 Summer
Mt Harmony Farm Carriage House 2014 Summer

The building (above) is the carriage house (or cottage) I live in, as it was last summer. The sooty part of the wall is from the pellet stove, which I am using now in the winter with great satisfaction. But even though it was nearly 0°F last night I still prefer to bundle up in clothing than to use a lot of pellets or keep the house too warm and get a headache! So I keep the stove at “1” rarely even a “2” and have not yet even turned on the upstairs electric heat…On the left, behind the bent door, is the “garage” where the farm and snow clearing equipment are kept…

This next photo is one I snapped not at all by accident of the white donkey, who looked to me just like a unicorn peering from behind the trees! I love this picture because it captures the magic of the past summer and why I fell in love with the NEK and Sheffield and this farm and its owners, Marc and Steffi, and VERMONT!!!!

Unicorn Heres loooking at you

I can’t recall if I posted these next few on Wagblog or only on FB but here is the farm after our first snowfall a week ago (actually it was not at all our first at all, only the first big one I was present for). We had a foot of snow at Thanksgiving again and more last night on top of this apparently unnamed “mountain”!

Snow in November at Mt Harmony Farm!
Snow in November at Mt Harmony Farm!
Mt Harmony Sheep in Snow November 2014
Mt Harmony Sheep in Snow November 2014
Farmhouse and sunrise on snow in Vermont 2014
Farmhouse and sunrise on snow in Vermont 2014

Finally a few photos of Wag herself in her new Vermont digs, doing her “thang.”

Pam at table drawing a small sketch before she starts painting

Pam Wagner Nov, 2104

(below)

Pam dressed to the nines and pretending to paint for the camera…In reality I never change out of my grungy gray tee shirt and jeans, and would never paint in such good clothing!

The Artist, dressed to nines and pretending to paint for the camera!
The Artist, dressed to nines and pretending to paint for the camera!
Pam Wagner with new 6" square oil painting based on Don Miguel Ruiz book, THE FIFTH AGREEMENT
Pam Wagner with new 6″ square oil painting based on Don Miguel Ruiz book, THE FIFTH AGREEMENT

Pam displaying results of her oil painting adventures, a picture based on a a very short book that means more to her than almost any other, THE FOUR AGREEMENTS by Don Miguel Ruiz and his newest, written with his son, THE FIFTH AGREEMENT…

Painting is “Sometimes a Dreamer has a New Dream”

In Recliner, reading about artist, Alice Neel
In Recliner, reading about artist, Alice Neel

Above is Pam in recliner in Vermont cottage, reading about one of her favorites artists, Alice Neel…

Pam, drawing in  recliner
Pam, drawing in recl

Drawing in recliner

Cooking up a storm with T=day leftovers, nov 2014
Cooking up a storm with T=day leftovers, nov 2014

(Above) Kitchen area in winter time….Pam W cooking, late at night in November, 2014

You can see that since I came back from the summer it has gotten a lot more crowded….I brought as much as I could pack into a 14 foot truck and gave everything else away. Which was a lot. I donated ALL my furniture to FreeCyclers, including my bed and my recliner. ALL my books went to a teacher at the Cheshire Correctional Institute or their library, except a few precious ones, including the Alice Neel volume. And most of my other items except for art supplies and art work, and cold weather clothing and a few expensive items I knew I would not want to have to purchase anew. But most of my things had been bought at thrift store to begin with and many years ago to boot, so it would have cost more to lug them with me to Vermont than to buy them again, used, once I got settled there.

All the furniture that you see was there when I got here and belongs to the owners, Marc and Steffi. Of all that you see, only the artwork on the walls, and the easel, and the white floor three-bulb lamp are mine…

Frankly I would love to “downsize” even more than this, but do not know how (except for clothing, which is all used and while I like what I have I NEVER wear it)…I have used nearly everything I brought with me, and if I have not, it is only because Marc and Steffi have something here. However, when I go somewhere else, which may NOT be fully furnished, I know I will be glad that I did not toss everything in a fit of pique with “stuff”.

Sorry about this mundane post. I needed to make these photos for my mom, who is experiencing dementia and may not even quite know where I am. I did make taped phone calls that go out to her every night at the same time, telling her that I love her and am moving to Vermont, but I have not been able to contact her “in person” otherwise, since I cannot call her and she is no longer able to do email . So I will write her a letter and enclose these photos. I figured why not also show them to my readers…(and I hope not bore them to tears at the same time!!!

8D

Love,

pam

Papier Mache Art and Recovery: An Update on Thanksgiving 2014

I wrote some or most of this in 2009 but I want to rewrite and update it..

Art, capital A, saved my life. It did more than that. Art gave me a new life, new hope, and something to get up for in the morning. It’s not that I’ve stopped writing. But I had been writing in a vacuum for a long time and needed an outlet for my creative urges that involved more than just my brain. Oh sure, writing involves the hands, too. But not in the way I mean. What I needed was, well, what do I mean? In some sense I needed more activity, if only because my poor brain shuts down and goes to sleep whenever I read, and it simply capitulates to narcolepsy whenever I am sedentary. I have indeed tried standing up while reading and writing, but this doesn’t work for someone whose feet swell very easily. And I find that standing up is just more distracting than anything.

But also  I felt an intense to make things, create objects or works of art that could be seen and touched and even smelled and if scratched or thrown to the ground, heard. I had no idea in 2009 that in 2014 I might even write a couple of rap songs before I succumbed to the impulse to retreat into self-imposed total mutism. If I were VIncent Van Gogh, I might even want to taste my art, but I will try to stick to real culinary arts when that urge overtakes me as I do not at the present time wish to be poisoned by cadmium red etc. Nevertheless, despite my lifelong love for words, I still wanted to create something physical, not just an imagined  or recalled world in words, however long-lasting.

I have always needed to work with my hands. I once wrote a poem called Hand Hunger which some silly psychoanalytic candidate insisted was sexual rather than seeing the references for what they clearly were, to making and creating and building with the hands, to MANUAL LABOR and not to — (sheesh!) masturbation! I mean, how stupid and dim can you get?

Anyhow, I needed to make something or do some sort of craft or artwork. Fearing/Knowing that I could not do “real art,” (YASS,that was ME only a few years ago, telling myself that I could never paint a face! Listen up all ye who think YOU can not  do art!) that I was not the stuff of which true artists are made, I always gravitated towards the crafty side of things. (But pray tell, what stuff is that, Pamela?)

So even when I – on a manic whim – dove into sculpture, creating that llama-in-a-day, Dolly the Llama,

Dolly the Llama at show

 

 

 

 

 

 

 

the result was mostly folk art, which is to say, unsophisticated, rustic, and at best a craft-like work. Sure, I was pretty proud that I’d made a lifesize animal that actually stood up firmly on its own four legs. But with a deli-container-head (underneath the papier mache) and huge mailing tube body, scarcely concealed, big enough to have once held a large amateur telescope, it didn’t look much like a llama. In fact, the result was not much more than that tube covered with a few layers of paper and glue, and all of it painted red. Nevertheless, I was happy enough with “Dolly the llama.” I have to confess though that it took me a entire year after the psychosis and mania were treated to finish her. Her saddle blanket have fooled many into tugging at the finge to see if it is real or not. a trompe-l’oeil — eye fooling — success that pleased me no end.

But a year-in-the-making was too much time to complete a craft or artwork, even a life-size llama. I came to dread the work by the time I got to applying the last few strokes of paint. You really need more drive than that to do art, but I didn’t seem to be able to sustain the energy or enthusiasm for much of anything. in fact, I’m not at all sure how I managed to write even my part of the book DIVIDED MINDS given those obstacles.

Then, during my hospitalization in 2007 it seems one obstacle was overcome: on Abilify plus the Abilify-tempering Geodon I suddenly had both energy and stamina* (see bottom of post for a later 2014 discussion of this). Or perhaps it is simply that the medications enabled a “well me” to come out, someone who could sustain an artistic effort, even if it was for the very first time. Given a different life I would have been doing this sort of thing all along had I known it was possible, had I had that kind of stamina… But I didn’t think about this, no, for me there was no looking back.

What I did not know at the time I wrote those words back in 2009, or at least  the connection I was unable to make, was that I had actually been on that same antipsychotic drug combination for a several years before this sudden transformation. But in late 2007, however, a small vascular malformation in my frontal lobe hemorrhaged. This was a small bleed, to be sure, but I later felt and some doctors have also agreed this was not impossible, that the timing was such that the bleed itself might in some sense have been responsible for the sudden production of Decorated Betsy

Decorated Betsy: Lifesize Papier Mache

 

 

 

 

 

 

 

 

 

and as my new-found compulsion to do art as well as the felt inability to stop…

 

Since that time I have jokingly said, “Well, a little brain damage (in the right place) never hurt anyone.” Of course, that is indeed only a joke. because brain damage almost always DOES hurt people. But in this case it seems to have wrought a miracle in my life.

 

 

Over the years since Dec 2007,  I have created many pieces, large and small, from bowls to two large tortoises and two geese, even a  “crazy fruit” bowl. Also a large seated man, a child detachable from her hassock (not quite finished) and several small birds. My female sculpture, the Decorated Betsy, even won a NAMI national contest on creativity and mental illness. But why tell you about them. I will upload a few photos instead.

I am going to try to show you them chronologically, but without the  many bowls I have made along with way, except for a few that are particularly special to me. Note that all the sculptures incuding a few that are not shown here, have been donated to someone or some organization, However if anyone is interested in purchasing a new sculpture, I  do accept commissions.

This is the Dream Tortoise, otherwise known as Yurtle the Turtle, which is about 3 feet in diameter. It was my second animal, but my first turtle.

 

DreamTlooking up

The prescription that this brightly clad psychiatrist holds in his hand reads: Dr John Jumoke, Rx: Art, Poetry, Music.  I thought, well, that  is one shrink even I wouldn’t mind seeing!

Psychiatrist Dr John Jumoke with Rx for Art, Poetry and Music
Psychiatrist Dr John Jumoke with Rx for Art, Poetry and Music

 

Trudy, papier mache child seated on paper mache hassock
Trudy, papier mache child seated on paper mache hassock, donated along with Dr Jumoke to Otis Library in Norwich CT.

 

Crazy Fruit Bowl with Mini-Melon
Crazy Papier Mache Fruit Bowl with Mini-Melon

 

Papier Mache Goose for Ruth
Papier Mache “Herr Goose” commissioned by Ruth S, one of my favorite artists and mentors.

 

Herr Goose after revisitation for repairs...Click on the photo to make a close up and you will notice neck "feathers and the difference it makes with old fully decorated version.
Herr Goose after revisitation for repairs…Click on the photo to make a close up and you will notice neck “feathers and the difference between this and the no-gold fully decorated version.

 

African Queen of Paranoia, without the large gold cascading earrings that I made for her but which catch the light too much to photographed.
African Queen of Paranoia, finally photographed with the large gold cascading earrings that I also made for her. Reminiscent, so i have been told, of the bust of Nefertiti…

 

African Queen of Paranoia (reminiscent of Nefertiti)
African Queen of Paranoia (reminiscent of Nefertiti) You can see that this resemblance was purely accidental, The bust was mostly an exercise in balance!

 

 

 

Papier Mache Bowl, painted with  slimemold motif and papier mache apple
Papier Mache Bowl, painted with “slimemold fruiting bodies and plasmodium” motif, also papier mache apple

 

Bird in Cage - Papier mach by Pamela Spiro  Wagner
“Standish” Bird in Cage for Tim – Papier mache by Pamela Spiro Wagner
Wading BIrd
Wading BIrd-given to Joyce Kamenitz, MD. Paper bird painted with nail polish, made by Pamela Spiro Wagner, placed on cellophane covered mirror with stones and soil mixed with polyurethane and glued to mirror.

 

papie-mache bird in tree banches made for sister by pamela spiro wagner,
Papier mache hummingbird bird in tree branches made for sister, Martha, by pamela spiro wagner,

 

Dr Geuss:  large Papier Mache Goose  made for the Northeast Kingdom of Vermont's Human Services
Dr Geuss: large papier mache goose made for the Northeast Kingdom of Vermont’s Human Services Approximately 3 feet tall

 

Tim with Papier Mache Turtle I made for him
Finaly, my dear friend and art collector, Tim with papier mache Turtle I made for him (so you can get an  idea of the size) Turtle’s head is large but the photo was also taken at angle so it looks larger…Notice copper sneakers, two of them with laces!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*As for Abiilify and Geodon “causing” my stamina and better endurance? I dunno what to say? I have little social stamina even now. But I stopped the Geodon almost as soon as I restarted it. I just feared taking any drug that prolongs the QT interval, one, and isn[t  even approved in Europe for heaven’s sake! Why is that? I can think of two reasons. One is that it is NOT effective at all, not even enough for them to fake-believe it, or two, it is too dangerous for the Europeans even to subject their mentally ill to it.  There may be other reasons why the European Union declined to approve Ziprasidone, but I cannot think of any other obvious reasons.

 

As for the Abilify, well, I have taken it, more or less, since I was in Care Bed, largely because they got me onto it and I am scared, frankly to stop it…And yet, I do have to “get myself” to take it each and every day, stop myself from simply removing it from the slot in the pill tray that it is in…I should. slowly, but I am afraid, I confess. My therapist at the Northeast Kingdom Human Services told me yesterday that I came extremely close to having been forced into the hospital this month…and she is worried about me if I do not take the fricking drug. But I do not believe it does a danged thing for me, nothing bad either, nothing bad that tis obvious at any rate…But what will it do down the road, and what was that stuff going on with my mouth when I was OFF it??? I want to know but I know no one will tell me or even test me for TD, because they do not want to KNOW…They do not want toi know if the  drug is causing brain damage because of the consequences of their KNOWLEDGE both from me and for them.

FUCK THEM and FUCK ME. I don’t know what to do. Everyone has an opinion and everyone has a different opinion and because I do NOT TRUST MYSELF to know myself or my needs, I listen to everyone at least temporarily. I listen to everyone! But I cannot trust what anyone, any one single person tells me, because I do not actually trust any single person to know a goddam thing about it OR to tell me the fucking truth. That  is the problem. Even Nancy, the APRN, who admitted that the drugs were imperfect and very broad targeting, etc seemed to be too enthusiastic for them, rather than trying to find a way NOT to use them. But that may have been because I myself raised a stink about their having taken a WHOLE bottle of expensive pills (GEODON) from my bags at CARE BED and not returned them to me,…I did not like that one bit.

i mean, I am not going to overdose or sell the meds, but I want what I came in with, and they are MY pills, goddam it! Wh=at right does ANY one have to take them from me! So i partly agreed to the Geodon just to get my bottle of pills back, only then it turned out that they wanted to give me a weekly tray so I would try to be compliant …so I did not get the entire bottle only a week’s worth which I frankly am not even taking.

 

I do not want to take any pills except for what I FEEL in my soul I need! I NEED 1) methylphenidate, or I cannot stay awake to do anything, esp not to drive any farther than 10 minutes  away, if even that. I start yawning about 15 minutes after I wake up…You may think this is a bad drug for someone with a propensity for psychosis but having narcolelpsy is NOT my fault…I cannot stay awake for the life of me. And that was true well before I ever took any other drug. 2) I need topiramate because I really fear seizures, and because if it just reduces my headaches by one a week, it is worth it. I take severall vitamins in larger than usual  but not mega-doses. I take a very small dose of a thyroid medication also, which I would not want to stop…Do I NEED Abilify or Geodon? Some people who have known me for  years and in and out of hospitals say “Yes, absolutely!” some others say, No, not if you reduce the dose very very slowly..”

 

I do not have ANY inkling myself, none at all, but I want to believe NOT…I do not feel that these drugs do a thing at all frankly. Except bad things, especially in the case of Geodon. I do not usually like it when people tell me what to do, but I wish wish wish in this case that SOMEONE with influence would indeed tell me what to do. Precisely..and convince me. But no one is in that position, not any more. I am just alone and fucked…My therapist practically said, no she DID say: f you end up in the hospital it will be no one’s fault but your own, because you won[ take the Abilify….What sort of thing is that to tell me??? Should I just accept that and be quiet or what? Is she right? I didn’t like it one bit. I felt utterly abandoned and scolded and also basically told, well, you heard! It WILL BE YOUR FAULT! YOU TAKE THOSE PILLS OR WE BLAME YOU!!!!

 

Enough of this shit…I should, I suppose, have written something about my gratitude for this lovely holiday, the original one that presaged a wholesale slaughter of our good “Indian” buds we had over for the first T-day…ha ha ha.  And how grateful I am for this wonderful country that treats everyone “equally” and with compassion and kindness (justice? Oh well, we need not mention JUSTICE, need we?Justice goes without saying, don’t it???) Ha ha ha, of course if you are melanin-challenged you might not agree that justice nor social compassion…But some folks in MO, and a certain MO town these past few days and nights have come to a different understanding about such things.

 

Okay enough for the “holy-day” chatter from me for now.

 

Gotta go pace the driveway.

 

 

POEM THAT CAN FORGET BUT NOT FORGIVE

THE POEM THAT CAN FORGET BUT NOT FORGIVE

 

This poem is afraid

because I am afraid.

This poem is always cold,

and shivering, making my teeth clatter

like cheap tin tableware

on a bare plate.

This poem wants to die,

and be rescued too late

to regret it.

 

This poem has been all its life scared,

and still is: scared, trembling

on the brink, trembling,

knowing the truth that lies

beyond the lies

told over and over,

though it has never been taken in.

 

This poem has a voice

small, smoke-rasped, hungry,

and it has much to say

about what really happened

when no one else was there

to stand to protest.

 

This time it wants to be heard.

This poem wants to be heard!

It will spit and curse and claw

out bejesus if it has to,

this poem means to be heard!

 

This poem will tattle-tale

sit back and smile smugly.

This poem will wring satisfaction’s neck

and revenge will taste like chocolate.

This poem is sad as water, poor as sand.

This poem wants to live well,

but it doesn’t know how.

 

© Pamela Spiro Wagner, 2009 (from WE MAD CLIMB SHAKY LADDERS, CavanKerry Press, Fort Lee, NJ)

I may have posted this before but it is especially relevant at the moment because i have been mute for more than 6 weeks now and do not know why it has lasted or what to do about it…

Why Dr Steve Balt, Psychiatrist, is Not Sure Medications Work… And GOOD for him for saying so!

Antipsychotics - NOT

From KEVINMD.COM and Steve Balt’s WONDERFUL ThoughtBroadcast.com

Why I’m not sure that psychiatric medications work

STEVE BALT, MD | MEDS | JANUARY 25, 2013

I have a confession to make.  I don’t think what I do each day makes any sense.

Perhaps I should explain myself.  Six months ago, I started my own private psychiatry practice.  I made this decision after working for several years in various community clinics, county mental health systems, and three academic institutions.  I figured that an independent practice would permit me to be a more effective psychiatrist, as I wouldn’t be encumbered by the restrictions and regulations of most of today’s practice settings.

My experience has strengthened my long-held belief that people are far more complicated than diagnoses or “chemical imbalances”—something I’ve written about on this blog and with which most psychiatrists would agree.  But I’ve also made an observation that seems incompatible with one of the central dogmas of psychiatry.  To put it bluntly, I’m not sure that psychiatric medications work.

Before you jump to the conclusion that I’m just another disgruntled, anti-medication psychiatrist who thinks we’ve all been bought and misled by the pharmaceutical industry, please wait.  The issue here is, to me, a deeper one than saying that we drug people who request a pill for every ill.  In fact, it might even be a stretch to say that medications never work.  I’ve seen antidepressants, antipsychotics, mood stabilizers, and even interventions like ECT give results that are actually quite miraculous.

But here’s my concern: For the vast majority of my patients, when a medication “works,” there are numerous other potential explanations, and a simple discussion may reveal multiple other hypotheses for the clinical response.  And when you consider the fact that no two people “benefit” in quite the same way from the same drug, it becomes even harder to say what’s really going on. There’s nothing scientific about this process whatsoever.

And then, of course, there are the patients who just don’t respond at all.  This happens so frequently I sometimes wonder whether I’m practicing psychiatry wrong, or whether my patients are playing a joke on me.  But no, as far as I can tell, I’m doing things right: I prescribe appropriately, I use proper doses, and I wait long enough to see a response.  My training is up-to-date; I’ve even been invited to lecture at national conferences about psychiatric meds.  I can’t be that bad at psychiatry, can I?

Probably not.  So if I assume that I’m not a complete nitwit, and that I’m using my tools correctly, I’m left to ask a question I never thought I’d ask: Is psychopharmacology just one big charade?

Maybe I feel this way because I’m not necessarily looking for medications to have an effect in the first place.  I want my patients to get better, no matter what that entails.  I believe that treatment is a process, one in which the patient (not just his or her chemistry) is central.  When drugs “work,” several factors might explain why, and by the same token, when drugs don’t work, it might mean that something else needs to be treated instead—rather than simply switching to a different drug or changing the dose.  Indeed, over the course of several sessions with a patient, many details inevitably emerge:  persistent anxiety, secretive substance abuse, a history of trauma, an ongoing conflict with a spouse, or a medical illness.  These often deserve just as much attention as the initial concern, if not more.

Although our understanding of the pathophysiology of mental illness is pure conjecture, prescribing a medication (at least at present) is an acceptable intervention.  What happens next is much more important.  I believe that prescribers should continue to collect evidence and adjust their hypotheses accordingly.  Unfortunately, most psychopharmacologists rarely take the time to discuss issues that can’t be explained by neurochemistry (even worse, they often try to explain all issues in terms of unproven neurochemistry), and dwindling appointment times mean that those who actually want to explore other causes don’t have the chance to do so.

So what’s a solution?  This may sound extreme, but maybe psychiatry should reject the “biochemical model” until it’s truly “biochemical”—i.e., until we have ways of diagnosing, treating, and following illnesses as we do in most of the rest of medicine.  In psychiatry, the use of medications and other “somatic” treatments is based on interview, gut feeling, and guesswork—not biology.  That doesn’t mean we can’t treat people, but we shouldn’t profess to offer a biological solution when we don’t know the nature of the problem.  We should admit our ignorance.

It would also help to allow (if not require) more time with psychiatric patients.  This is important.  If I only have 15-20 minutes with a patient, I don’t have time to ask about her persistent back pain, her intrusive brother-in-law, or her cocaine habit.  Instead, I must restrict my questions to those that pertain to the drug(s) I prescribed at the last visit.  This, of course, creates the perfect opportunity for confirmation bias—where I see what I expect to see.

We should also make an effort to educate doctors and patients alike about how little we actually know.  The subjects in trials to obtain FDA approval do NOT resemble real-world patients and are not evaluated or treated like real-world patients (and this is unlikely to change anytime soon because it works so well for the drug companies).  Patients should know this.  They should also know that the reliability of psychiatric diagnosis is poor in the first place, and that psychiatric illnesses have no established biochemical basis with which to guide treatment.

Finally, I should say that even though I call myself a psychiatrist and I prescribe drugs, I do not believe I’m taking advantage of my patients by doing so.  All of my patients are suffering, and they deserve treatment.  For some, drugs may play a key role in their care.  But when I see my entire profession move towards a biochemical approach—without any good evidence for such a strategy, and without a fair assessment of alternative explanations for behavior—and see, in my own practice, how medications provide no real benefit (or, frequently, harm) compared with other treatments, I have to wonder whether we’ve gone WAY beyond what psychopharmacology can truly offer, and whether there’s any way to put some logic back into what we call psychiatric treatment.

100 Things To Do If You’re Sad

These 100 things to do when you are sad was created by an 18 year old named “Natalie” and I think it is just wonderful. If you cannot find anything that cheers you up in this list, surely just the reading of it cannot help but distract you a wee bit from your sorrows. And if not, my suggestion is that you try to write your own, because that surely will! In fact, writing such a list is on MY list of things to do when I next need such a distraction, and if I ever need prompting, someone please remind me to do so.

By the way, if a certain Paloma happens to read this, please know that you did #30 on the list I have reblogged — I hope it was not because you were sad! But whether you know it or not, and despite the irritable nature of my response, you really made my day! You write about walking around with a smile? Well, that was what I did after I received your email. Thank you.

Talk About Abilify with Pamela

ARC_Talk_About_Meds_Banner_Pamela

 

 

 

I have been asked, by The Recall Center http://www.recallcenter.com, see also http://www.recallcenter.com/xarelto/side-effects/ to “talk about my medications” so here I am, talking about my “favorite psychotropic drug, NOT..”: Abilify.

 

Why do I take Abilify?

 

I take Abilify, well, why do I take Abilify? I was prescribed Abilify because of the diagnosis of schizophrenia many years ago, and I usually take it along with another anti-psychotic drug (Geodon). But frankly the reason that I, I myself, take Abilify for now has nothing to do with psychosis or schizophrenia. I take Abilify simply and only because I have this weird feeling that it helps me write and do art. Ever since I have been taking it, or the two drugs together, I have had no trouble doing art at any time or even writing when I want to. The extra plus is that I can finish longer term projects, ones that I start on one day and have to finish over time. In the past this was a problem, but it seems to not be so difficult for me any more. I do not know for certain whether this is due to the effects of the Abilify/Geodon combination, but it feels like it, since I was never capable of finishing projects so easily and reliably before then. On the other hand, I believe that I can do these things myself now, and that once I get used to living here, in my new state of Vermont, I will choose to sloooowly go off the medications for good.

 

 

How do I remember to take my medicine?

In truth, I often forget to take my medications, but for the past thirteen years I had a Visiting Nurse come to remind me. And now that I live in another state, where this service is not available, I have a med tray that is delivered weekly. I hope that I will be able, by seeing this tray openly on display on my table, to remember to take the ones I want. At least for as long as I want to take them.

 

I have been asked about side effects of this drug, but I would say, 1) all “side effects” of drugs are the effects of the drug, and you cannot tell a person that she is only suffering “side effects” especially if they are serious enough to cause distress. 2) there are very serious and troubling effects possible with Abilify, so my experience is not necessarily typical 3) I used to feel very irritable on Abilify, but no longer 4) usually I add Geodon to help me sleep and calm the anxiety that Abilify can induce

 

Where do I go for Medical support? I just a few weeks ago moved to Vermont, so I do not yet have a Primary Care Provider, but I do have a psychiatric nurse practitioner who will see me – so far, at any rate – once a month. For medical issues, at this time, I do not know whom I will see, but in Connecticut I used to have an APRN at a doctor’s office. I also was able to get to an Urgent Care center easily, in CT. That is not possible here in rural VT. So in the event of a medical emergency, I do not know exactly what I would do, except call 911 and hope for the best!

 

Before taking Abilify, or ANY anti-psychotic drug, here are the questions that I think you should ask your doctors: You should ask, first of all, why he or she is prescribing an anti-psychotic medication for you. Does he or she believe you are psychotic? If not, why prescribe such a powerful and possibly devastating drug? And if so, why? Doctors should be willing to answer this openly and honestly and if they will not, then I do not believe that you should listen to their advice, but get a second opinion. You never know who might derive financial gains from prescribing a medication that is not available generically. Also, why is your doctor not being honest with you? I would never feel comfortable in a situation like that…

 

 

Ask your doctor what to expect after taking this drug and when to expect the effects, good or bad. What does he or she anticipate you will experience as a benefit and what he or she thinks you might experience on the down side? Ask them to be honest about this and why they feel it is worth the cost/benefit ratio to you.

 

Abilify is extremely expensive and non-generic until 2015, when a generic form is scheduled to become available. So if you can, I would ask your doctors about why they are prescribing this particular drug and not another. There may be very good reasons for it, such as a low incidence of weight gain, and little sedation, at least at doses below 15mg. Nevertheless, I would want to be certain that there were no financial inducements such as stock holdings in the pharmaceutical company involved etc.

 

 

There are ALWAYS risks involved when you take pscho-active medications, or any drug, but anti-psychotic drugs can be especially problematic for some people. Even though Abilify causes fewer problems with massive weight gain, for many people this is not always the case and weight gain as well as Type 2 diabetes, with or without weight increase has been known to occur on Abilify. Over-activation and irritability have been reported frequently, in my experience. And many people I know who have taken Abilify have told me that they have trouble sleeping if they take it at night.

 

Published research suggests that 30mg of Abilify is no more “effective” than 15mg. From my own experience, I can only say that at 15 mg Abilify is quite activating but at 20-30mg it becomes suddenly sedating and less helpful. This is why so many people refer to Abilify dosing as “Less is more.” They mean in some sense that the lower doses work better than the higher ones, unless the sole goal is sedation, in which case I would say there are better drugs for that purpose and safer ones.

 

As for drug interactions, I am not aware of any important ones.

 

Finally, the three main things I wish I knew before taking Abilify are what I wish I’d known before I took ANY anti-psychotic drug many years ago: that if I took what they gave me, and kept taking it, 1) I might be disabled for the rest of my life 2) it might induce chronic/episodic psychosis – i.e. stop the natural process of recovery in its tracks 3) NOT that my brain’s neurochemistry was already “out of balance” but that my brain and its neurochemistry would be changed and destabilized by the drug itself…

 

That is what I wish I knew before taking Abilify. Before I take any drug from now on, I will find out these things and determine for myself whether the cost/benefit ratio really makes sense.

 

 

But on the whole I would say that NO DRUG developed in the last 20 years has been adequately or honestly researched for any pharma company to make a claim about either its efficacy or its safety. NONE. So I would on that basis probably never take a new drug from now on. There is not a drug company out there that I trust to have done ANY new brain research, since it’s all based on junk and garbage theories that arose from “back researching” Thorazine, which was bogus in the first place. So why would I want to take a drug that was developed from research coming out of that cesspit?

 

I am 62 years old. I am NOT suicidal and I certainly do not want MDs with murder on their brains to euthanize me with their psycho-drugs, or to use me as some guinea pig to determine how much control they can have over people…NO MORE DRUGs, NO MORE DOCTORS, NO MORE HOSPITALS AND HOSPITAL ABUSES.

 

 

I may take a couple of drugs today in order to survive the transition from CT to VT, but you must understand that my brain was already damaged from the years of having been given them against my will. So I HAVE AN ALREADY DAMAGED BRAIN, from the medications I’ve already taken.

 

I do not advise anyone with a more or less intact brain to take an anti-psychotic drug, not ever, not if you can avoid it and certainly not for “the rest of your life.” NEVER take any drug on an ongoing, “forever” basis. ALWAYS re-evaluate your need for it.

 

And that is all I am going to say about Abilify. If you take Abilify for “depression” you have come to the wrong place. Nevertheless, I have written a blog post just for you. Do a search on “Add Abilify” and you should find it. But you won’t like it any more than this one. Sorry about that.

 

Pamwagg’s Art from the Wonderful “Care Bed” in Northeast Kingdom, Vermont

BioHazard Head and Face with Bugs...first drawing done at Care Bed in St Johnsbury Vt in Nov 2014 by Pamela Spiro Wagner
BioHazard Head and Face with Bugs…first drawing done at Care Bed in St Johnsbury Vt in Nov 2014 by Pamela Spiro Wagner

 

Silent Scream by Pamela Spiro Wagner, 11/2014
Silent Scream by Pamela Spiro Wagner, 11/2014 Drawing # 2

 

Fist Protesting Restraints
Fist Protesting Restraints Drawing #3 (restraints would NEVER be used at Care Bed)

 

Listen Up Collage -- A message more than art.
Listen Up! Free Your Soul! Collage — More a message about my treatment in Connecticut hospitals (never at Care Bed!) than “art” (#4)

 

Rocking Chair at VT "Care Bed"
Rocking Chair at VT “Care Bed” Drawing #5

 

Care Bed Living Room with bedroom in background
Care Bed Living Room with bedroom in background (at night) Drawing #6

 

Mischief and Kitten among Ornaments!
Mischief and Kitten among Ornaments! Drawing #7

You Can’t Really Change Your LIfe, After All, Can You?

You Spew Poison into the World
You Spew Poison into the World

 

Of course you can’t change your life. Your “giants go with you wherever you go,” as Ralph Waldo Emerson wrote many many years ago, and it is still sadly true.

 

I left Connecticut, thinking I could escape, at least the hospital torture, but I cannot escape the voices that hate me and the demons that I carry with me, the fact that I burden the world, poison it when I exist in it, and that wherever I go I leave a slime of pollution and hatred..I cannot help that. It is a genetic flaw, no matter what good I try to do, the generosity I practice, the kindnesses I have done and preached, it all goes for naught in the end, when the poison leaches from my marrow and through my skin and permeates the world. People feel it then and run away, screaming…

 

I know this and feel it. and I cannot take it any longer. I have had it. Lord knows I have tried and tried to obviate it, to deny it, to remove the stain or fix it, but it has never worked. I am done. I can’t do it any more. It is over. I cannot deal with the voices and the evil that I am and cause any longer. It is so clear to me that others want this end from me too, because although they talk a good game about help and programs to assist me, they actually refuse to make them available to me, and deliberately– DELIBERATELY —  turn a deaf ear when I overtly say, I NEED HELP NOW…How much more obvious and clear spoken can I be?

I will NOT beg for my life or my skin. No. I do not deserve that. And if not one wants me alive or intact, then there is a reason for it…and I know what it is, as I have stated. So if I get the message that “this is it” today, at my appointment again, that We HAVE NOTHING FOR YOU, that YOU ARE ON YOUR OWN, that “we do not really care what happens”. then it is OVER…I cannot care for myself, the devil, and I know what must be done…

I have done all I can, I really have. Do not try to tell me I haven’t tried for 62 years as bravely and carried on ALONE as I could possibly do it and be. But I cannot do it any longer, I am sorry, But this is it. Either PROVE to me that YOU CARE THAT I EXIST AND DO NOT WANT ME TO DO…whatever.

 

No , in fact YOU cannot do anything, any of you out there. Frankly. This is strictly between me and the folks here tasked with making sure I am safe and it is clear that I have poisoned all of them already, I have used up my quota of caring and assistance and that is that. It’s gone. It’s over. I’m gone. GET LOST. YOU BAD RUBBISH. We have had it with you. You are worthless shit.

 

Goodbye.  I don’t know what will happen to me. But I can’t do this any longer.

HOW SAFE ARE PSYCHIATRIC MEDICATIONS?

My only addition to this article is to answer this question “How safe are Psychiatric Medications?” with a resounding, “Not safe at all!” And then to ask the even more important question that the USA FDA doesn’t ever ask: How Effective are Psychiatric Drugs? That should be the fundamental question but I don’t think anyone dares ask it let alone answer it honestly, not at least someone without a large stake in the answer.

I challenge anyone to ask and answer that question next: How EFFECTIVE are our psychiatric medications? It would I think be extraordinarily difficult at this point, at least in this country, even to think about such a question, so set are we in our thinking about such things that we cannot even begin to consider the notion that perhaps these drugs were NEVER effective ever, or no more effective than just placebos all along. It would take extraordinary courage to acknowledge that it was always the doctor/patient interaction that mattered more than anything, this and the natural history of each mental or emotional disturbance,..In fact, I have yet to meet any single person who would consider this to be a possibility…But oh how refreshing it would be were that person to step forward!

Anyhow, this reblog is very interesting indeed, and as good a place to start as any in a reconsideration of how safe such meds really are.

Sheri Lawrence de Grom

The American Recall Center/Personal Experience
by – Sheri de Grom

Far Too Many Pills - Photo Courtesy of Death to the Stock Photo Far Too Many Pills – Photo Courtesy of Death to the Stock Photo

Each day begins with my swallowing a handful of pills and injecting a shot. Each medication has more side effects than I care to think about. Four of the pills I swallow in the a.m. are for panic attacks resulting from a nasty case of PTSD. I’ve worked hard in therapy and thought I had managed to put everything in a pretty box and handed it to God. The move to DC I’ve talked about a lot brought on other events leading to more severe panic attacks. After my second brain injury, I was diagnosed with Narcolepsy and here came another pill and more panic. I suddenly found myself in one dangerous situation after another and I had no idea when my body would betray me and…

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