Social Housing and Nimbyism

The Neighbour began violently banging on the walls at 6 am. I was quietly dressing to catch a cross country flight.  The banging went on for 10 minutes and was so forceful as to cause the pictures to fall off the wall.  My friend, who I was staying over with said,
“That’s the neighbour, she’s always banging on the walls and ceiling.  Everyone has complained.  I’ve even complained to the super.  Nothing is done."
Suddenly the banging is on the door.  My friend opens her door.  She is tired and in her housecoat. The neighbour is wide eyed, crazy, yelling.
“Stop banging on my walls,” she shouts.  My friend holds up her arm to stop the young woman from barging into her suite.  She backs up screaming ‘Don’t touch me. Don’t touch me.”  Every action, every statement is an sophisticated attack. She, the aggressor, is positioning herself as the victim.  “You bang on my walls every morning at 8:30.” It’s 6 am I’ve been getting ready quietly so as not to disturb my friend.  She usually leaves for work before 8:30.  But that isn’t the point, is it.  This is a distraction.  She’s attacking here and now.
My psychiatrist mind has flipped into gear because of the danger she presents. She’s either psychotic or a sophisticated borderline sociopath.  She’s sweating profusely. That could be from the banging or she may be in withdrawal.  Her irritability could be heroin withdrawal but such paranoid projection is more common with marijuana psychosis, crystal meth or heroin psychosis. My crystal meth patients become like this.
Of course she doesn’t look like the stereotype of the mentally ill or addicted. She’s well groomed, maybe 40’s, plain but not unnattractive.  My friend says she has a job.  The rent for suites here is standard Vancouver , well over a thousand. It’s a nice neighbourhood but no neighbourhood is safe from drugs or even sociopaths.
The whole idea of ’social housing’ has the drug addicted and ex convicts increasingly housed in nice communities because such orderly civilized environments ameliorate the insanity and violence of these populations. It’s like the distribution of difficult children in normal classrooms. The normal students provide structure for the ill mannered.  The alternative is the ghetto. The Vancouver Downtown Eastside is a breeding grounds for crime, violence, drug addiction and insanity.
Government agencies, civil and human rights associations, ex convict advocacy activists, mental health agencies, families of the ex convicts and the mentally ill, all serve to get their individual concerns cared for in the best of districts. At the other end of the spectrum the rich and privileged don’t accept ‘social housing’.  They have gated communities. They are protected by their wealth.  The middle class can no longer afford the same so increasingly they’ve turned to Nimbyism.  Not In My Back Yard.
The whole idea of ’social housing’ developed 50 years ago.  That was the height of community movements, middle class values, law and order. The police and authorities in general were widely supported by the citizens.  So many of the adults had returned from World War II.  They had seen up close what ‘chaos’ was like.  They’d seen or heard about the concentration camps. The Jewish doctors, gay composers, ethnic minorities and anyone different had been gassed.  The Soviets had raped everyone in their ‘liberation" especially teen age girls and boys.  After the long nightmare, everyone wanted peace and order.
It’s 2015.  The police have no authority.  My police friend left the force when she said “I set out to be a crime fighter.  I was reduced to being a ‘crime recorder’.  Police are simply not allowed to do anything. When they catch criminals red handed  rich lawyers  get privileged judges to let their clients off on a ‘technicality’. “  Justice is a revolving door.
I treat victims of physical sexual violence. They’ve lost limbs. They have nightmares for years.  They’re still in treatment for the horrifying consequences of their assaults when the criminals are being released back into the community.  They’re terrified. Some of my patients are the victimizers. They’re terrifying.
Increasingly the judges, once the admired back bone of society are being exposed by the rapacious media.  Everywhere the media exposes to the masses the one bad apple and demands an enquiry into the whole barrels. There’s no money for front line resources so police and mental health care givers are forever forced to cut corners or ignore all the while million dollar enquiries make everyone rich writing up more plans and protocols that no budget has resources to address.. Media logic goes like this.   One northern judge in British Columbia was caught for pedophlia so all judges are pedophiles. The former head of the Supreme Court of Canada was a slurring alcoholic so all judges are drunks and alcoholics.  The judges increasingly are throwing the police under the bus, more concerned apparently with popularity than justice.    Everyone in authority knows there will be no one to protect them in retirement.  When the police learned that the proposed new gun laws for disarm police on retirement suddenly the police were no longer en mass in favour of highly restrictive gun laws.  All those in the know want to be living in a gated community. Private security firms prosper like never before.
The industry of housing as “mental health and addiction’ treatment simply  takes the money from true treatment, psychiatrists, physicians,  nurses, psychologists, addictionists, counsellors, standardized scientific therapies and certified treatment facilities and certified recovery houses with treatment components. They give the money instead to ’slum landlords’. These smart businessmen raise the ‘rent’ on their unliveable facilities because they’re overnight called ’social housing.  When the tenants destroy them the landlords give the repair bills to the health care system.  When the facilities are repaired to a liveable state they rent them out at high priced Vancouver prices to ‘normal’ people who now will live in these improved bed bug and cockroach free apartment complexes. The money designated for addiction has paid for the upgrades.
Meanwhile with ‘social housing’ the violent, the insane and the drug addicted are distributed through communities. They’re ’somebody’ else’s problem”.
Psychiatrist used to be able to ‘committ’ for treatment the mentally ill who were violently insane and destructive in the community. Yet today the government has closed down all the asylum and mental health beds with the result that there are simply no resources. The ‘bar’ for admission to a psychiatric facility is raised so high that even psychotic schizophrenics who publicly chop off the heads of their neighbours are quickly discharged  free in the community.  The assumption is that these patients are taking medications that will stop them from being violent. The trouble is that there are so few resources that when patients stop taking medications its often months or another violent episode before anyone notices that they are no longer getting their monthly injections or following up with the treatment team.  The sex offenders from the criminal system are similarly placed in the community with marvellous ‘parole’ and ‘probation’ idealized recommendations.  These pretty documents no doubt make judges feel good about their ‘intent’. The trouble is with no jails and no community staff and castrated  police and a thoroughly unnaccountable destructive deceitful media and vigilantte Facebook justice, there’s no follow through in fact.
When I said to the crazy lady, “You were the one hammering on the wall. We both heard you and you need to leave.”  She shouted spitting in my face, “Shut the fuck up you fucking old man.”  I backed away.
I am old. I’m in my 60’s.  My friend is in her 50’s.  She’s focused her life on health care administration and raising children. She has no training in dealing with criminals or psychotics or violent young women who know all the angles and claim they’re the victim. They have a monopoly of victimship and can bring massive beaurocratic  governmental to bear on kindly innocent people like my friend, the sweet older quiet lady, who has never harmed anyone.  Everyone she has ever met will speak to her good manners and respect for others and loving nature. This woman likely has a rap sheet a mile long. Yet the courts and agencies no longer respect individual histories. Everyone is equal before the law.  Character doesn’t count in the courts. In the street Vigillante justice runs on how many people you know and how many hits you can get on Facebook by taking a video out of context.  Just be sure to sound politically correct.
I work in the mental health and addiction field.  People like her don’t ‘just happen’.  She had all the ‘lingo’ rehearsed.  The best defence is an offence.  She was like Hitler where claimed his destructive tank blitzkriegs were ‘defence.’  Politically correctness is all in the language. Get the right marketing jingo and everyone will believe you should pick up the lump end by the clean end and that this clean end exists and is apparent to all.  The neighbour went from loud to catastrophic. She’s a ticking bomb, a social terrorist. Now’s she’s hammering on walls and ceilings and doors. What will she do next.  My  friend admits that everyone in the building is afraid of her.  She certainly frightened me.
I’ve always been afraid of drug addicts. I know the neuroscience of drug addiction. I’ve watched my little cockapoo dog growl defensively, whenever anyone delirious on marijuana, crack or crystal meth approaches. Animals sense the unpredictability of people who are emotionally anaethetized  bubble boys and girls. These people are able to inflict all manner of emotional and physical trauma without feeling anything in return because they’re drugged.  They’re also always the ‘victim’. Right.
Theres’ a tug of war between the rich with ‘gated communities’ and the new ‘bunker houses’. These two or more story bunker houses were all the rage in medieval towns. Then a family home had to stand against the riots that plagued the city.   Few if any small windows on the lower floor with the big windows on the second or third floor. Reinforced doors.  That’s what the rich have begun to demand.
Barricaded private complexes are a response to the increasing decline of law and order. The public structures are all but collapsing into increasing chaos and brute force rule.  If my friend hadn’t put up her hand to stop this woman pushing her way forward she might well have barged in. Bullies take advantage when they see weakness.     This neighbour would have phoned the police  too and claimed she’d been assaulted if it was one on one. The first come first serve justice system gives the edge to the complainant.  Criminals and frequent fliers know the system.  Everyone knows in Canada that ‘false allegations’ are standard but that there’s never any consequence.  As one judge asked about slander said, “everyone lies in court, it’s my job to assess whose lying more.”
Everyone doesn’t lie and no judge can do what lie detector tests and countless psychological scientific studies have proved.  But what we do know in psychopaths can act better than the innocent. The innocent are no longer the victims.  Everyone is the new ‘victim’.  "Nobody is right when everyone is wrong."  The criminals all know the system and rule because frankly there is no other authority.
“Shut the fuck up you fucking old man!”
There is lawlessness here and now.  The question is when will the media do it’s job and report that.  Will parliaments and congress make the pendulum swing back to the centre. Will judges be supported in making the tough decisions.  Will the rich want to face the ‘peasants’ again.  Have they so quickly forgotten what saying ‘give them cake’ caused.  Do the corporate czars really think they can protect themselves from the Lennins of this world.  The middle classes, the truthful,  the educated, the professionals, the artisans, the engineers, the businessmen, all those whose represent the meritocracy, will they be protected because they don’t do well in chaos. The Pol Pot killed the doctors and university teachers first then killed half the country later throwing a once thriving country into the dark ages.
Hitlers first act was to make the Brown Shirts. The brown shirts became his personal army. They were made up of pedophiles, drug addticts, criminally insane and sociopaths, bullies.
A day doesn’t go by when I don’t hear of a person being brutalized by their neighbours.  The real fear of investing a million dollars in a Vancouver property is not the predicted tsunami and earthquakes but more importantly the very reall possibility of the dangerous or just offensive neighbour.  I know of dozens and dozens of such cases.
Personally I’ve lived the last few years in what is essentially a gated community.  After hearing so often of such complaints I witnessed first hand what is perhaps best called ‘evil’.  When the psychotic is powerful there is little language to capture the depth of insanity one must face.
I feel sorry for my friend.  I get to leave.  Her sleep has been disturbed many nights.  My day began with a threatening confrontation which my friend says is routine, If she’s not banging on her door she’s banging on the woman above her, the man beside her, shouting in the halls or threatening people coming through the vestibule with her.  She’s clearly way out of control and has been for a very long time.  No one is a bout to control her soon because frankly the system will punish the good rather than engage with this evil.  The system lacks the mechanism, resolve or even the intelligence to address it.  It’s not an individual.  It’s a disease.
If it’s not in your neighbourhood.  It’s coming.  It is coming to your neighbourhood.  

The Recovery Paradigm - Insights and Challenges - Dr. Nady el -Guebaly - ISAM 2013, Kuala Lumpur

N. el-Guebaly - Professor, University of Calgary, Alberta
Also editor of Textbook of Addiction Treatment: International Perspectives - due Nov.2014 (www.springer.com)

(These are my rough notes which I hope give an idea of the depth and breadth of research and presentation at this ISAM conference. For those interested i would hope you would go to the sources and authorities in this field. Dr. El-Guebaly is one of the truly great leaders in the field of addiction medicine. His presentation was packed with information. He has slides rich in detail as well. I only here caught a part of the whole. His research papers are superb and I recommend to anyone reading these his depth analysis of current and often very thought provoking aspects of addiction medicine - W.Hay)
Historically AA developed, then White saw wider context
Then Mental Health , Chamberlain 78 "On our Own - recovery as a reaction to the shortcomings of deinstitutionalization
APA 05
Recovery emphasizes a persons capacity for hope, treatment guided by person's goals and ambition, focus on wellness, resilience and active participation
A "cure' Is possible for most and 'partial recovery' for some
 Recovery from Mental and Substance Use Disorders
SAMHSA 2011
4 dimension - health, purpose, home , community
10 guiding recovery principles
 person driven
holistic
trauma informed
Respect
hope
A: Stategies As Chronic Disorder
- recovery doesn't have an end point - there's no such thing as graduating'
recovery oriented states of care - core polices , bridge integrating Addiction and Mental Health
Alternative Institutions - peer-based organizations, and support centres, and roles, live and recovery coaches
Challenges - licensed professionals versus commercialization

B: Monitoring and Sustenance of Recovery
-other chronic illnesses - diabetes hypertension, asthma require lifetime assertive continuing care and regular check up
-from 6-12 month retrospective Follow up to Concurrent Recovery Monitoring (CRM)

In Malaysia you may not have secular assets but you have religious assets to draw on.

Addiction Day Recovery Survey 2013
Thoughts about Recovery
Hope and restoration of meaningful life
Ongoing process
Healing and growing

Disconnection - with individual, within treatment, with concurrent services

Concurrent Capable Competency Framework, (CCCF) - Alberta Health Services, Oct. 2013
Recovery Orientation - safe personal qualities and formal qualifications and experience
Staff Competency Domanis
Behavioural - adaptability etc
Technical - knowledge
 Looking more in-depth at what makes for successful treatment and recovery.

Lying and Health

Research by Anita Kelly of University of Notre Dame showed that the more people lied the more unhealthy they were. She did her study by coupling lie detection with a lie detector to periodic health surveys.
Linda Stroll strudied trust and health find that those who were least trustworthy had more stress due to increased conflict in their lives.
Outwardly sociopaths and psychopaths appear at least for awhile to have success but all the while their 'insides' are 'putrifying.  It was apparent that the relationships of liars lacked substance and depth. Possibly Fathers who lied couldn't 'love' their children with depth or their families as such  because lying is associated with an unhealthy environment.  Mothers who lie are prone to excessive conflict as well.
http://www.suntimes.com/news/metro/14285134-418/avoiding-lies-can-help-your-health-study-finds.html

What is mental health?

Freud summarized mental health as the ability to love and work. The WHO definition is a bout a page long and essentially says the same with the addition of 'play'.
The definition I use then is that Mental Health is the ability to love, work and play.
Love was best defined in a little book called the Art of Loving by Erich Fromm.  In that book he summarized the development of the thinking about love over history separating falling in love or lust from standing in love or adult love.

Love is not a scientific term. The term "attachment" is the word used in research for our principal relationships.  These first refer to the relationships we have with our parents and brothers and sisters and extended family, blood relations.  The term love also refers to our relationships with friends and others less closely related to us in our  community. It's that whole emotional interconnected world of relationships that at it's highest has been described ideally as our relationship with our 'higher power' or God, for lack of a better word.  As well given the golden rule of "love your neighbour as yourself" or "do unto others as you would have them do unto you", it refers to our love of ourselves in the healthiest sense of that.

Work refers primarily to our contribution to the community.  This is predominantly defined as work that in our society translates directly into money. The community as a whole attributes a monetary role to different work. Individually I may feel that my working on my guitar playing is 'work' however society has said by its basic reimbursement that it is willing to pay Keith Richards for this work but to date has never paid me enough that I could be self supporting.

Adults to the best of their ability cooperate in society and work to be self supporting.  Work is humbling in that it usually means service to another and doing what I might not necessarily want to do at any particular time.  Even great artists might rather run through the sprinkler than practice violin but if they did just that they would be less likely to succeed in their work.

Volunteer work is work which though like work doesn't get 'paid' but serves the community and involves cooperation and factors of reliability and responsibility. Philanthropy and charity are examples of volunteerism.  They are considered altruistic rather than narcissistic.

Self care is a kind of work.  To date communities have been loathe to pay for self care because it's a fine line between the basics of self care and self pampering.
In the area of work, subjectivity and objectivity are always an issue.  Tom Sawyer contains a story about work being made to be fun.  Work doesn't have to be painful but it's always inherrently a 'service' to others and 'valued' by community. Many a golfer would call what he is doing 'work', like those who 'play' on the computer or doodle.  They may even present a long face and seek to elicit pity from those around them. The word "billable hours" came to be used in the workplace to address "slackers" no matter what their story.

In contrast play is all that leisure entails.  It's part of a balanced life. It's rest and recreation.  Society doesnt' pay individuals to play though there has been a controversial movement in this direction with state bought call girls being supplied for the disabled in some european districts.  Workaholism has been idenfitied as such a 'disease' because it has a short shelf life and may lead to significant individual and community dysfunction. Even military studies show that a balance of work and leisure results in better productivity.

Mental illness is defined as dysfunction in work, social or leisure activity as a result of a predominantly mental or emotional or cognitive cause, Commonly physical illness is associated with accompanying mental illness. Often the physical illness presents as a depression or even a psychosis.  Addictions present at first a mental illness with work usually being last effected since it supplies the habit but eventually addiction will lead to a variety of physical illness.

Mental Health is also disease prevention.  WHO studies of longevity showed that people who lived longest worked and had a purpose in their community as a consequence of this contribution.  Isolation is associated with misery and those who are happiest have a close relationship with family and friends.  Maintaining friendships and family relationships often requires effort just like showering and doing laundry can appear onerous at times. This persistence in face of lack of immediate positive reinforcement is one of the positive psychological strengths that Seligman addresses in his studies of Authentic Happiness.
Leisure involves exercise. There are no obese people over 100 years of age.  Exercise and leaness, especially measured by waist size are associated with good health and longevity.  Longevity without quality of life isn't a particularly attractive destination.  The Nun studies showed that those who were least likely to develop dementia were those who remained socially interactive and continued to learn and participate in community.

Mental health isn't all that much different from overall 'health' and certainly good physical health depends to a large degree on the recognition of the interaction between body and mind.
Psychosomatic medicine is the modern and postmodern approach to all disease that says that body and mind aren't separate but work together.  The toe bone is connected to the head bone. Good physical health and good mental health work together contributing to each other.

TGIF

Friday evening. It's the end of a long day. The government cuts to mental health are showing in the office already. People who once would have seen a counsellor or service are now going to their family physicians and specialists. The low cost alternatives have been cut so that emergency rooms and private offices are faced with greater line ups. I could be book years in advance as others are but am running as much of an emergency department as so many other specialists. There's just no resources. The economics of the marginalized is that they can't afford psychotherapy. They can't afford to be in all that is now privatized and what was once keeping them out of the emergencies, doctors and specialists offices.

There's no demand by doctors and nurses for this crisis. The waitlists are attrocious. And of course, as the research on these types of waitlists show, mostly the mentally ill and those with addiction are the losers. So now we hear talk of Euthanasia.

Eugenics on the horizon as private security forces increase to army sizes. It's frightening but we must have faith. There will be hope. Maybe after the parties die down the short term cost savings will face the long term deficits. Beds opening in asylums again. Streets being cleared after Picton Trials and whatever else. There must be some serious thought being given to this somewhere. People like me and too many others are little boys with fingers in a collapsing damn asking how much longer and when will we be paid for this. Cherry picking everywhere and the people coming through the door older, poorer, sicker and some more "beautiful people with more beautiful problems". The rewards of better life and longer life brought on by success create their own new set of challenges.

Where once a young patient was on no other medication today the patient comes in with multiple medications and disabilities. It's an aging population. We are living longer. Be thankful. Its Friday and I know Monday I'll be fresh again to face the week of sadness, pain and anxiety. But Fridays I always feel that someone isn't listening to the cries in the streets.

Or if they are like me they have no miracles and must ask God the meaning of suffering. Why do we have the means to imagine peace but can't seem to get people to live it? How come we can imagine paradise but not find it? Or worse envision health and near immortality but struggle with depression and anxiety.

It's Friday. I'm thankful for the work. But were there cure today I'd take another job for sure. I pray for wellness and joy for all who now struggle day to day in these tough uncaring time. And I pray that I have done good, brought light in darkness, reduced the suffering and lessened the fear. Suicide is a permanent solution to a temporary problem. I do hope I am still convincing. Live. Life. Live life and prosper.

TGIF, thank God it's Friday. Tomorrow is another day. Hooray.