As a mental health advocate, I find it very difficult to explain to my Russian - speaking family what exactly I am doing.
Aside from all the pressure that I am dealing with because I am unable to earn a livable wage with my writing, I also have a difficulty translating some of the themes that I am writing about without stigmatizing myself and other members of the mental health community.
This could probably make a good TED talk subject and there will be a day when I will run my mouth on camera about this social, cultural and linguistic barrier.
In the first half of the Twentieth Century, the development of psychiatry in the Soviet Union, in the United States and in Europe followed roughly the same course. Soviet psychiatrists even were the first ones to question the effectiveness of lobotomy and banned it before their colleagues in United States did.
BEFORE AND AFTER THE COMMUNITY MENTAL HEALTH ACT
United States became very different after the Community Mental Health Act was passed in 1963. As 90% of the long-term mental institutions were closed down, people with varying degree of mental conditions had to figure it out on their own. Some gravitated towards recovery, others ended up living on the streets and prison system became the largest mental health provider in America.
Liberalization of the mental health system in America did not create a reliable alternative that kept all of the mental health community protected after mental health care shifted towards the outpatient services.
However, before 1963 an average hospital term for schizophrenia was 11 years.
Such lengthy inpatient treatment left very little room for self-exploration of the underlying psychological trauma that lead to the mental illness, yet it also kept people with severe mental disorders from living on the streets, from using street drugs and alcohol and from being incarcerated.
“NORMAL” AND “CRAZY”
With many behavioral problems remaining undiagnosed and unaccounted, some behaviors, such as domestic violence (wife beating, beating of children) or drinking were perceived as a norm. Very few people would have been willing to “turn themselves in” because the doctor would have prescribed them medications with strong side effects, or they would have been locked up for many years. On top of that, a stigmatizing label would follow them for the rest of their lives.
This created a discrete gap between "normal" people who managed to stay away from psychiatry altogether and people who were “not normal”. Sometimes those “normal” people would take out their anger on their wives and children, drink a lot, get in trouble with the law, but they were still normal. In the past, the society tolerated many opportunities to convert distress into anger and to take this anger on some scapegoat, especially for the male populations. (Specifically white males in the America, examples of such anger release include lynch mobs in the South).
People who could not live under pressure of hiding their symptoms became the outcasts and scapegoats. They were labeled with stigmatizing names, medicated and kept in the hospital. As early pharmaceuticals had heavy side effects and were not very effective, people with mental health problems were warehoused in the institutions.
On top of that, a variety of social restrictions were applied to them for being mental health patients, turning them into convenient abuse targets for those very “normal” people who needed to take out their anger on someone who would not fight back.
Generally, this fear of seeing a psychiatrist causes people to drink excessively and to look for weaker scapegoats to take their anger which in turn propagated trauma in the society. Personally, I experienced this disregard towards people with mental health problems and served as a scapegoat in my family for more than a decade.
MARXISTS AND THEIR INSTITUTIONS.
In the Soviet Union, the idea of warehousing mental patients in institutions resonated well with the Marxist ideology. Marxist-Socialist dogma has very little consideration for personal spiritual growth and transcendence of the trauma, yet it does not allow for people with mental illnesses to live on the streets or in extreme poverty. A visit to the (state) doctor or a hospitalization would have resulted in a permanent record in the passport. In Russia, people with money still prefer doctors who practiced in private, to stay off the state radar. Generally people are not discussing such visits even with their close friends as this may cast judgement and cause them to be disrespected.
Since the secrecy concerning mental health problems, the fear of stigma and the inpatient model of mental health remained unchanged in the Soviet Union and then in Russia for many years. As patients spent decades in institutions where they were drugged with heavy tranquilizers and would only see other patients like themselves, they became naive, isolated and could not readily advocate for themselves.
On top of that, the generation of my parents and grandparents experienced very little opportunity to practice freedom of speech in their lives.
American mental health advocacy movement stemmed from the civil rights movement of the 1960s. Disenfranchised mental health advocates followed the footsteps of racial equality movement and secured some victories, while in Russia no such widespread movements existed. Although in the dissident intelligentsia, some people were prosecuted by being sent to the mental hospitals, educated people were not ready to talk about it, except for the few poets of that time. In the 1991, Russia emerged from the Soviet Union with many other types of victims of the state policy and a heavy luggage of old social fears taboos; there was no place to discuss the alternatives to the way the society viewed and handled mental illness.
Stay Under The Radar if You Can.
A man can drink and beat his wife in Russia and that is somewhat of a social norm, he may be forgiven, although it is punishable by law and aggressive drunks eventually became divorced and incarcerated.
Yet it would be unthinkable for a person with a mental record to have a driver's license without paying a lot of bribes and obtaining a "clean" passport. (This choice was limited to the organized crime community.)
A code in the passport would render someone who has been to the mental hospital a second rate citizen for the rest of their lives. They would not be hired to management positions, the society would segregate against them and many opportunities would be closed to them forever.
I grew up with a family member who had to hide their mental health problems (or their traumatic imprints, as I prefer to call them) for their entire lives. Despite their behavioral problems, this family member graduated from a university, had a relatively successful career (in Soviet terms) and managed a team of thirty people at work. However their social life was somewhat impaired.
Some socially unrewarding behaviors (another one of my terms) erupted at home, among family members where that person felt safe to release tension. Mental health problems were passed to me, not genetically but because I formed my social stereotypes based on the behaviors of this family member; someone who had to hide mental health problems for their entire life, in a society that was very hostile towards people with mental health problems.
THE NEW LANGUAGE THAT ALLOWS FOR THINGS TO CHANGE
More gentle, less stigmatizing language that consists of euphemisms and of some more relevant scientific terms is a result of human rights activism and years of articulate mental health advocacy that took place in the English speaking world. Such possibilities to change the language are virtues of a society that has freedom of speech.
By reducing the amount of stigmatizing, terms and increasing the amount of constructive terms in our language, we gave ourselves an upper hand in the conversation about race and racism, about sex and sexism, about sexual identity and orientation and about behavioral health, although there is still a lot of work to do.
We created a narrative that allows for new reforms to take place and for less traumatizing social patterns to reoccur. ACEs narrative would take a long time to establish itself in a society where spanking is considered a proper way to raise children. The boundaries of societies and cultures are defined by the boundaries of language, thus for trauma psychology to catch in Russia, a set of indigenous terms has to evolve in Russian as a result of social changes within the culture. Those vernacular terms have to co occur with the social growth in the society and it would be very difficult to import them from another language. Some neighboring, western Slavic countries may eventually influence Russia if it wasn’t for the political isolation.
"One Flew Over The Cuckoo's Nest" was a rather popular novel in Russia at one point. I never read it in Russian, if they translated it well, that may be a good first step in creating the narrative.
Writers such as Ken Kesey and Philip K. Dick helped establish the narrative for the mental health advocacy in America. It may be said thatanother very peculiar cultural phenomenon of the 1960s helped the mental health cause along with the Community Mental Health Act, signed by John F. Kennedy, redefining mental health in America forever.
ANOTHER PROPHET WHO IS NOT WELL UNDERSTOOD AT HOME.
When I try to explain to my family members what Mental Hospital Diversionary Respites are, why they are important and why I would like one to open in Frederick County, I have to use common words that are available in Russian to describe the problem.
What comes out of my mouth either sounds too clumsy or it sounds as if I am advocating for lunatics to run the insane asylum. Some of the terms that I use in my advocacy work in English are simply not present in Russian. Thus, I am yet another prophet who would not be understood in his own home country.
Yes, there are some people in America who think that all psychos need to wear straitjackets and be kept in chains, drugged up on thorazine, yet their narrative is not dominating. They just won't get very far in society with their angry talk.
In modern America, even the most covertly racist politicians can no longer use offensive racial slurs in public because the narrative had shifted away from racist terminology. We have to be aware that such changes in language, in thinking and in the narrative are fruits of the civil rights movement.
They give us new tools to change our world for the better.
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