RE: [xmca] RE: mental health

From: Peter Smagorinsky <smago who-is-at uga.edu>
Date: Sat Jul 12 2008 - 06:12:53 PDT

Achilles, again I speak largely from experience here. I think that there's a
balance between attending to the neuroatypical issues (autism, bipolar
disorder, etc.) and attending to what's more strictly on the outside (other
people's attitudes, the social arrangement of material surroundings that
channel thinking about difference--see, e.g., accommodations for physically
handicapped people).

What we argue in the book excerpt, and what Leslie argues, is that it's
vitally important to create mediational contexts that both contribute to new
settings (when there are wheelchair ramps, being wheelchair-bound appears to
all to be less of a handicap) and new ways for people to think about
themselves; or as some research suggests (see Damasio in our review below),
new ways for the brain to encode perceptions.

This is not to say that some conditions do not require additional attention.
I take a medication for anxiety, and many people I know take antipsychotics,
depression medications, and so on. Undoubtedly there's some overprescription
of such meds, but many of us are glad to have the option.

One thing seems certain: We need more research in this area, so I strongly
encourage you to extend your investigation! Best,Peter

-----Original Message-----
From: xmca-bounces@weber.ucsd.edu [mailto:xmca-bounces@weber.ucsd.edu] On
Behalf Of Achilles Delari Junior
Sent: Friday, July 11, 2008 7:36 PM
To: eXtended Mind, Culture, Activity
Subject: RE: [xmca] RE: mental health

Thank you, very much Peter...
 
"Cook (2004) argues that relying simply on medication and counseling
is inadequate; that a broader environmental change that enables an
understanding and tolerance of difference, and gives young people
tools for managing their difference, is essential to helping young people
construct positive lives for themselves and in turn contribute to a more
humane society."
 
It's a beautiful and deep contribution. I really agree with this
orientation.
But, let me ask you: don’t you think that could exist a subtle distinction
between (a) “tolerance of difference related to inclusive education” and
(b) “(self)tolerance of mental pain”? I think about my own experience:
there are several moments in which I don't only accept my different
(dysfunctional) process, but desire overcome/master it... There are four
hyperbolic semiotic process that I recognize (and struggle with) in BAD
(bipolar affective disorder): {paranoia<->megalomania} (mania) X
(depression) {self-moralist<->suicide ideation}. And I know that if social
others learn to comprehend and accept these different semiotic ways of
means world and my own experience, changing "social situation" by
inter-mental mediation, my own personal sense for this process can be
transformed. But, even so, a paranoid delirium not always can be only
accepted. If we could understand cultural-historical genetical roots of
mental pain, can we do something to not only accept it, but even
overcome/replace its dysfunctional social/personal consequences?
Here, ariseesthe problem of “psykhotekhnika” again, an approach that
not only explains psychic process as function of social relations, but
socially
(and deliberately) constructs it too…
 
Personally talking, seems to be not too easy to me to engage myself
in social relations that could actually produce important functional
(and structural-dynamical) changes in my life - even more, since I
haven’t control about multiple social and biological determinations.
Things seems turns better or worse more in a casual than a determinist
way. But, by epistemological principles and with an emotional need to hope,
I know that social formation of mind is open to co-construction/
inter-constitution/co-existence (sobytie)… Along the years, Vygotsky’s
claims
(to create new psychology and new means to make people’s life better)
make me take this problem of psychology applied to mental health as a kind
of personal and professional challenge to my own mental (cognitive/
affective)
resources… (but sorry about my "ecogentric language" here, righ now, i will
control me better in future)
 
Oh, sure. One more operational question. Let me ask: is this “dissertation
of Leslie Cook” (“who looked at young women with depressive disorders
and the mediational means they use to make sense of their lives”)
available in any digital midia?
 
Thank you very much, for this opportunity of inter-constitution. I must
organize my reading tasks now, there are very important contributions of all

you here.
 
Achilles
Umuarama, July, 11 2008.
> From: smago@uga.edu> To: xmca@weber.ucsd.edu> Subject: RE: [xmca] RE:
mental health> Date: Fri, 11 Jul 2008 15:24:52 -0400> > Achilles asks: > Can
we really creat semiotical means to produce better mental health to people?
Or this kind of a goal is a mistake like possible Vygotsky´s or perhaps some
Vygotsky's followers' mistakes about 'social engeneering'?> > I would say
YES to the first question. I'll take a shortcut and paste something in below
from a book I've coauthored about The Discourse of Character Education
(Erlbaum, 2005, with Joel Taxel). It draws on the dissertation of Leslie
Cook, who looked at young women with depressive disorders and the
mediational means they use to make sense of their lives. My apologies for
the length of the following excerpt.> > > Mental Health and Character
Education> We have briefly expressed our concern that the issue of mental
health is virtually absent from discussions about character education. Yet
many students who come to school with a mental health problems are treated
as discipline problems of the sort measured as indexes of low character in
the proposals we have studied. We believe that it is important for any
character education initiative to recognize and account for mental health in
its conception of good character, both for those with nonnormative makeups
and those with whom they interact.> Mental health is the elephant in the
character education closet. The World Health Organization (2001) reports
that about 7.5 million children in the U. S.—12% of all children under
18—have mental disorders, nearly half of which lead to serious disability.
Jamison (1997) found that 20% of high school students had seriously
considered committing suicide during the year prior to his study, with most
having drawn up a suicide plan; suicide is the #3 cause of death of
teenagers between 15 and 19 years of age, often following from a depressive
disorder. Yet most parents and teachers feel that mental health issues are
poorly addressed in schools (Dowling & Pound, 1994; Rappaport & Carolla,
1999), many teachers have little understanding of how to recognize or
respond to students with mental health problems (Madison, 1996), and only
recently has mental health been identified as a reason to develop an
Individual Education Plan (IEP) for students.> These widespread
misunderstandings have resulted in many such students being regarded as
troublesome or lacking character in schools. Yet, as reporter Anne Imse
(1999) wrote following the Columbine school shooting tragedy, > Even teens
as dangerously troubled as Eric Harris stand a good chance of slipping
through the cracks in Jefferson County and across Colorado, failing to get
badly needed mental health care. There are serious roadblocks to getting
treatment for sick kids [including]> • State prohibitions against law
enforcement agencies telling schools about a problem kid unless there's a
conviction; > • Schools worrying about being saddled with psychiatric bills
if they recommend treatment, or even being sued; > • Not enough money
earmarked for counselors and counseling for the state's youth. > So, even
though Jefferson County school officials have become more sensitive to kids'
mental states . . . they remain hamstrung about arranging treatment. "We
have no place to go with them," said Clark Bencomo, a counselor at Green
Mountain High School. "All we can do is suspend or expel." "We are
oftentimes reduced to putting a kid in a place where they're safe, but it's
not the right program," added Kay Cessna, intervention services director for
Jefferson County schools. "There are not enough places." [One parent of a
child with disabilities complained], "They don't have the time, the
manpower, and they don't get it."
(http://denver.rockymountainnews.com/shooting/0516ment2.shtml) > Cook (2004)
finds this problem occurring in other states as well, reporting that
students with mental health problems are often put in special education
programs or disciplined when they act out, either as a consequence of their
makeup (e.g., a child with Tourette’s syndrome’s involuntary profanity) or
in response to the taunting they face from their peers.> Yet a mental health
professional would surely argue that the problem is not a lack of character
and the solution is not to punish students with mental health problems.
Rather, a broader understanding of mental health among students and
faculty—the sort of attention to climate we found in the states from the
Upper Midwest—would contribute to a more sympathetic and less punitive
environment for such students in school. Indeed, Damasio (1994) argues in
his somatic-marker theory against the classic Cartesian mind/body binary,
instead positing that brain and body are integrally related not just to one
another but to the environment. A change in the environment, he finds, may
contribute to changes in how a person processes new information (cf. Luria,
1979; Pert, 1997); that is, in response to developments in the surroundings,
the brain will encode perceptions in new kinds of ways. > Conceivably, then,
changes in school climate can contribute to the emotional well-being of
students whose mental makeup falls outside the normal range. The therapy for
such students is still widely debated. While medication and counseling have
benefited many with nonnormative makeups in their relationships with others,
the medical model has been criticized because it assumes that a normative
mental state is best for all. This criticism frequently comes up in debates
about whether medications for Attention Deficit Disorder are prescribed too
often for any students who have difficulty focusing in school. Some argue
that prescribing such medications is designed more to increase the comfort
levels of those around such students than to help those students
themselves.> The jury is still out concerning the question of whether people
with such diagnoses are sick and in need of medicine. Cook (2004) argues
that relying simply on medication and counseling is inadequate; that a
broader environmental change that enables an understanding and tolerance of
difference, and gives young people tools for managing their difference, is
essential to helping young people construct positive lives for themselves
and in turn contribute to a more humane society. Taking a punitive approach
to difference, she argues, is regressive and only makes life more fragile
for those characterized as different and more emotionally and cognitively
unhealthy for those who surround them.> >
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