Further confirmation that I am right, if any is needed, came today in the form of a column in the NYT by a schizophrenic. Her name is Elyn R. Saks and the article is titled Successful and Schizophrenic. In it, she argues, partially from her own case, that mental health professionals too often write off the lives of those diagnosed with schizophrenia without looking at the strengths and potential. I got the idea she was talking mainly about psychiatrists, and that’s important.
As a mental health professional for 20 years, 10 of them working as a “masters level therapist” in a major mental health center, I found myself in a kind of niche as that therapist who tried to work with patients (I always called them clients but I think that has gone by the boards as the medical model has triumphed). Imagine that! Frankly, most of my colleagues admired me for it and the outside professional community: advocates, community organizers, families, applauded efforts to treat the clients as people with a problem instead of patients needing care with a concomitant loss of agency. I always pushed for agency. I always pushed for self-advocacy.
All that only made sense to me given my education as a counselor. (I was a social worker and counselor for five years on a bachelors degree in anthropology before getting an M.C. degree, Masters in Counseling, a 60 hours terminal program at AZ State U. in 1973). We talked about the ideas of Maslow, Frankl, Watzlawick, Rogers, Pearl, and others who approached people as systems, products of their genetics, heritage, and environment. When I started working in the mental health center, all the talk was of community (we were a community mental health center and my actual work place was in a hospital which we would soon leave to start a clinic in an abandoned Catholic school so we could be in “the community”). We talked of systems theory and the medical model versus a more social view of man. Since our catchment area was in the segregated communities of Hispanics and Blacks, racist oppression and cultural differences figured prominently in our discussions.
I never abandoned those principles as the field, over the decade 1973 to 1983, when I left, turned more and more to the medical model. The drug therapy triumphed to the extent that now we can read in the NYT articles by psychiatrists who are discovering the value of talking to patients in addition to writing prescriptions after doing a check list of symptoms to generate the script. I read in a book on therapy that the same thing had happened toward the end of the 19th century when sufferers from not only mental illness but mental retardation were treated at facilities like homes and ranches and retreat centers where they could function as normal people to the extent their illness permitted. Improvement was seen but the medical profession stepped in and took over, turning the “guests” into patients, hospitalizing them and labeling them. Eventually drugs were discovered in the 1950s that could ameliorate or suppress symptoms and allow people to be put back into the community: thus the rise of community mental health centers. What we didn’t understand at least some of us was that “community” was set up in contrast to “hospital”; we thought it meant a return to something like the farms and homes where people had sheltered work and some expectation of a return to a normal life.
After leaving the field in 1983 and after a two year stint with Child Protective Services while I got my teaching certificate, I kept tabs and was informed that therapy sessions and home visits had been entirely replaced by assembly line meds-only treatment plans. I guarantee that plenty of therapists, social workers, counselors, and paraprofessionals continue to talk to sufferers from mental illness, but what insurance pays for is medical treatment. All of this in the service of studies that show little return on investment in what they call talk therapy and much greater return on a pharmaceutical approach with lip-service paid to supportive treatment. Plenty of counselors exist who do talk therapy but it’s expensive. My grandson is being treated by several doctors and psychologists and they do a good job, although medication plays a prominent role in their approach. Having worked in the field, with children for over half of that time, I am in no way against medication were it is not used inappropriately; I do think it is prescribed in a fashion to ensure insurance coverage and protect against malpractice charges. Sadly, it is also used to control children whose behavior has roots in matters that need attending to but never get attention because the meds suppress the unwanted behaviors. I recently read that a whole school district was put on meds to ensure the students’ longer attention spans. The reasons for their antsiness do not go unnoticed, I am sure, but they seem to be out of reach and meds are easily prescribed, making the pharmaceutical reps very happy.
Is there culpability here? Greed? Ignorance? Laziness? Unprofessionalism? There is some. But most of the operators in the field believe they are doing the right thing or at least all they can do. And here is the bridge to teaching foreign languages, which I take almost as seriously as I do mental health.
Upon taking up employment in the mental health center, I found large numbers of middle-aged Hispanic women being given tranquillizers and seen for a few minutes once every two months. Several of us set about investigating whether or not these women could be transformed into clients. We noticed first the secondary gains for these women of being able to go home with a bottle of pills and saying, “See what you are doing to me?” It may sound funny, but that was a function this mild medication played in the lives of people who had little education. The downside was being labeled “crazy”, a factor that kept many out of the health care system when they should have been in it. One young mother told me she would love to come talk to me but to do so would label her mother a failure as a mother.
Appreciation of these dynamics was in short supply, especially among the psychiatrists who came from an entirely different cultural world. They had little patience with their patients and did not see them as fully functioning human beings. In fact, they were likely to write them off since they were not suffering from a major mental illness.
We ran groups in Spanish, led clients through “drug holidays” and encouraged them to report changes in family dynamics, all features of their treatment and lives long ignored by the medical staff.
So how does this relate to teaching foreign languages, you may ask (go ahead)? When I entered the field I already was aware that college language majors in their senior year had very low proficiency in their language. Entering the high school situation, I found the same to be true for high school fl students. First year students had no proficiency, nor did second year, and when a few stayed on for a third and fourth year, they still had no proficiency. I read the research. I heard a professor at the U of Az who regularly took students to Russia report on their abysmal level of proficiency. Over and over, I saw failure in the field to do what it was supposed to do, just as the mental health professionals were failing to “actualize” their patients to the highest level possible.
What fl teachers seemed to be doing was exactly what the psychiatrists had done: write off most patients. Studies showed that the patient most likely to receive talk therapy and benefit from it were young, attractive, educated, White females (note that every psychiatrist we had over ten years in several departments were males). Studies have shown similar skewing of success in fl teaching: the logico-mathematical thinkers who thrive on charts and formulas, what the tprs-ers call “4%ers”. I set about to change that for my classes just as I set about, with colleagues, to change the cycle of depressions and meds for the middle-aged (seldom attractive, never educated) females, usually Hispanic. I also had colleagues in changing the fl paradigm; one in particular I hooked up with immediately I started student teaching, even though I had no intention of going into teaching fl. Brian and I logged hundreds of hours over at least 3 coffee sessions a day, discussing our classes, observing each other, and participating in each other’s activities (we still meet once a week for coffee). Fortunately, we had two district leaders in fl education over 20 years who were very positive toward teaching for communication and proficiency. They helped. Once in a great while, someone else would drift by who saw language as communication, not as a mental discipline to be mastered only by the gifted.
Now I am in a different school. My only support was a beggar’s democracy: no one cared what I was doing, as long as someone was in the classroom. So, like the group therapy for depressed, middle-aged ladies, I taught as I wanted, taking the First Year class from eleven my first year there, to 16 my second year, to 30 my third year, and to 50 the following two years (including this year). I got cut off, much as the psychiatrists had the final say in treatment plans, last year by being forced to teach grammar. This year it’s worse because I am teaching Spanish in addition to Latin (only 3 classes total, though), and trying to get kids to handle the paradigms in addition to getting to a reasonable level of proficiency when no one in the school cares in the least about proficiency (they define “rigor” as grammar).
You can see why I am retiring in May, no matter what. My only hope is that the revolution around proficiency goals and teaching via comprehensible input continues and that it eventually drives out the rule-getting rule-using approach that is so stultifying. And I would add my experiences with schizophrenics and other mental conditions match those I’ve described for depressed people. Be careful about incorrectly interpreting what I’ve said about my mental health experiences: unless you know the differences among situational depression, chronic depression, clinical depression, cyclic depression, depressive personality disorder, and many others, you had best just ask questions rather than trying to point out inconsistencies in what I’ve said about the mental health field.