A Theory of Monotheism – The Final Blog of 2023

By Dr David Laing Dawson

In the history (and pre-history) of religions, monotheism is a relatively recent phenomenon, perhaps less than 3000 years old. Before (and after) this development, humans devised and invented many gods, deities, spirits, supernatural agents – all presumably in the service of explaining or organizing events and information. Angels, demons, fairies, gremlins, ghosts, spirits, and single-purpose Gods. All to satisfy cause and effect. Or rather, our brains search for a cause or agent to explain an effect, be it drought, lightning, illness, suffering, good fortune, or simply a noise in the dark.

Each fairy, gremlin, demon or god served as an explanation for specific events that were otherwise difficult to explain. This in turn would lead to the development of rituals and practices to please or appease each single-purpose rather capricious deity. Yahweh, before “he” became the one and only God, was just one of many, each with specific spheres of influence and power.

Why did the shift to a single God come about? How would that fit into evolution and survival of the species?

This is my hypothesis:

We humans (and our hominid predecessors) start as families, then extended families, and then tribes (mostly of the same gene pool), competing for resources, for watering holes, hunting grounds, arable lands, fishing grounds, gold, slaves….. To survive, these groups have to act in an organized and coordinated way, and this calls for a strict social structure. And at the top of this social structure we have, of course, the alpha male, followed by his brothers and sons, cousins, nephews……(which is not to discount an alpha female calling the shots in the background).

The alpha male rules and decides when to fight and when to move on. The larger and more cohesive the tribe the more powerful and successful it will be warring over an oasis, hunting ground, or arable land.

But how large can such a tribe grow? A tribe ruled by a single human or hominid older male? For to maintain power and authority all citizens must see and witness this alpha male, his power and magic, at least now and then. And with a life expectancy of about 52 years, succession would have to occur roughly every 10 or so years.

How big could such a tribe grow and retain a hierarchical structure, retain loyalty to a single alpha male, a warrior king, and maintain some cohesion?

I haven’t found the answer to that question. But I am sure the largest of such tribes would not be able to grow as rapidly or as large as a tribe governed by the lieutenants of an all powerful invisible alpha male in the sky. It was a brilliant idea, sustained through its evolutionary survival value. You won’t be able to see him. Nobody can see him. But we will tell you what he says and what he expects of you. We know of this single or dominant alpha male in the sky (perhaps the first was Yahweh) from “divine” texts and the messages and stories his lieutenants bring us. And we know he demands loyalty, worship, and obedience. And if you stray you will be punished, in this life and the next.

Now our tribe can grow enormously, not be disrupted by death and succession, and all the watering holes will be ours, (“from the river to the sea”) and the senior males, the lieutenants, of this tribe, the imams, rabbis, priests, can live in comfort, safety and splendor.

Our development of frontal lobes and abstract/symbolic thinking allowed this. Survival of the fittest fostered it. It serves the alpha males well.

Of course such monolithic monotheisms will splinter at times, as new alpha males emerge and claim to speak directly to and for the true alpha male in the sky, to have been given a divine connection to that invisible alpha male in the sky. (Joseph Smith was 17 when he received his call). And of course some would take that even further and claim to be the son of the invisible alpha male in the sky.

So the invention of God, a single God, did serve an evolutionary purpose. It allowed for dramatic growth in the size and cohesion of tribes, tribes that could now conquer and enslave others. The gene pool would be perpetuated. The alpha males would live well.

A host of symbols would be required to perpetuate the myth of an invisible alpha male in the sky, not least of which would be overwhelmingly impressive, symbolically powerful, churches, mosques, and synagogues. Symbols, rituals, punishments, tithes, origin stories, rules, and prescribed times of worship. All developed to support what was at first a natural evolutionary strategy to perpetuate a particular gene pool. Survival of the fittest and the largest.

And like many human proclivities that at one time supported our survival and our rise to the top of the food chain, this worship and fear of an all powerful, vengeful, punitive invisible alpha male in the sky no longer serves us well. Might not the people of Israel and the people of Palestine, if they were organized, educated, secular, democratic, socially responsible societies, who held no mystical beliefs in being the soldiers of an invisible alpha male in the sky – might they not find it easier to share that land of milk and honey?

When we compare the societies in the world that are doing well, by all measures (health, peace, women’s rights, equality, levels of violence, education…..), we find those with the highest percentage of non-believers are doing much better than those societies with the highest percentage of believers.

In fact, ascribing power to a supernatural agency, be it an explanation for violence, poverty, illness, war, or climate change, allows our species to avoid the obvious and momentous fact that we (we the people) are the only agency that can improve our lives and maybe save the planet.

Ascribing such power to a supernatural agency allows us to abrogate our own agency, apart from offering thoughts and prayers.

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Thanks to everyone who read our missives this year and don’t forget to come back in 2024. Have a safe and enjoyable holiday season.

Ontario’s Shameful Barbaric Practices for some with Schizophrenia

By Marvin Ross

Soleiman Faqiri had a promising future ahead of him when he enrolled in an engineering program at the University of Waterloo in 2005. He was bright, personable and a good athlete but, like some at that age, he developed schizophrenia. And while many with this illness can do reasonably well with proper medical care, it was not to be for Soleiman.

On December 15, 2016, he died under brutal circumstances in the detention centre in Lindsey, Ontario. This December, seven long years later, another coroner’s jury ruled that his death was a homicide but the police may or may not re-open the investigation. Two police forces had previously investigated the circumstances of his death and came to no conclusion.

What happened to this promising young man was despicable but not unusual in Ontario.

Soleiman did not tolerate his medication well and was thus not compliant. Whether his doctors worked with him on that was not made clear but his psychotic behaviour brought him into contact with the police numerous times. He lived with his family and was very close to his mother but when he had problems, the police took him to hospital. His last episode was a dispute with a neighbour and it was alleged he brandished a knife and the neighbour sustained minor injuries.

On that occasion, the police charged him and took him to jail where he was remanded to the local detention centre to await trial. Questions were raised about his fitness to stand trial while his parents attempted to visit him in jail but they were denied. Then, on December 12, Soleiman appeared in court in Oshawa, Ontario via a video link from the jail. His brother, Yusuf, commented that he looked terrible and told the court that the family had struggled to place him in a health-care facility and get him the medical attention he needed — “Soleiman needed help in a medical institution”, he said, “not time in a jail”.

When asked by the Crown, Yusuf replied that Soleiman looked worse than he had ever looked in the 11 years since his diagnosis. The jail nurse told the court that Soleiman was not speaking to anyone, refusing his medicine, not eating properly, and lying on the floor, making no eye contact. The court ordered a psychiatric assessment but while he waited, he was in segregation. Three days later, he was dead.

According to testimony reported in the Toronto Star and by Canadian Press, Soleiman was lying in his cell covered in feces, urine and vomit. Guards took him by wheelchair to the showers but he refused to get out of the shower once he was in it. He was throwing water and soap at them but they finally got him out and took him back to his cell with his wrists and feet cuffed. He spit on a guard and was hit. He resisted going into his cell so guards twice used pepper spray on him and forced him to the ground. An alarm was sent out and a large group of correctional officers entered Soleiman’s cell.

Prison guards took shifts trying to subdue him and, in addition to the pepper spray, they used a spit hood while he was on his stomach. He died at 3:45 that afternoon with more than 50 injuries to his body with bruised lacerations to his forehead, with multiple bruises and abrasions on his face, body and limbs from blunt impact trauma.

Details of that occurrence can be found here based on a freedom of information request by the Toronto Star.

An investigation by the Kawartha Lakes police concluded they had no grounds to lay criminal charges against anyone for his death. A 2017 Coroner’s Inquest concluded that “it was unknown what injuries were from his struggle with the officers, and they couldn’t ascertain the cause of death.”

The family appealed to the CBC investigative show, the Fifth Estate, to look into the death which they did and I highly recommend watching it if you can stomach the graphic pictures and video. It is available at https://www.youtube.com/watch?v=VgcmP3PU1Sg

They managed to get all of the reports which they turned over to an independent pathologist, Dr John Butt. His conclusion was that Soleiman’s death was the result of restraint causing what he called excited delirium. There was evidence of pressure being applied to his neck so that he could not breathe. The police interview with the first paramedic on scene revealed that the paramedic could not get a straight answer from the jail officials when he asked what happened.

There was an eyewitness to the altercation who would not talk to the police but he did talk to the Fifth Estate. He was in the cell opposite Soleiman’s and his description of the beating was vivid including how a guard had his knee on Soleiman’s neck (George Floyd?). When the Fifth Estate took their findings to the Chief Coroner with a request to re-open the investigation, they were told that Ontario had new evidence and a criminal investigation was being launched involving the Ontario Provincial Police.

The cause of death, according to Ontario’s chief coroner, Michael Pollanen,  was a direct result of the actions of the guards who beat and restrained him. It was the prone-position restraint and the injuries to Soli’s body that caused him to become hypoxic or have a fatal heart arrhythmia. Either individually, or in combination, the actions of those in the cell caused him to die.

That investigation by the Ontario Provincial Police based on the findings of the coroner, did not result in any criminal charges either. The police could not find criminal culpability.

A large part of the problem in Ontario was described by Howard Sapers, a former correctional investigator, who testified at the latest hearing. He pointed out that once someone goes into a correctional setting, they are no longer covered by the Canada Health Act. Any needed health care has to be provided by the prison at the prison’s expense and if they need to go to a community hospital, the prison must pay for it. Ontario decided in 2018 to change that after convening a panel of experts who made the recommendation but then Ontario failed to follow through.

Sapers continued to testify that if you have a doctor and prescribed medication before you go into prison, there is no guarantee that you can keep that doctor and still get your medication. Plus, the medical staff work for the prison and are responsible to some prison administrator rather than a clinician. In his 12 years as a federal prison ombudsman, Sapers said the main complaint from prisoners had to do with medical care. Ontario has no prison ombudsman so complaints go to the general ombudsman who handles all complaints about the government.

The use of segregation of prisoners with mental illness is a long standing failure by Ontario who have ignored all orders to cease the practice. The case of Jahn v Ministry of Community Safety and Correctional Services, began in 2012 when Christina Jahn filed a complaint with the Human Rights Tribunal because she was in segregation for 240 days suffering with mental illness, addictions and cancer. In 2013, the parties settled with Ontario agreeing not to put those with mental illness into segregation unless absolutely necessary. Informing people of their rights was added in 2015.

Despite that, Ontario continued using segregation until the Human Rights Commission brought a contravention application because Ontario continued to ignore the agreement. That was resolved in 2018 when Ontario undertook to comply with a series of requirements when dealing with those with mental illness. In 2020, Mr Justice Cole released his report on Ontario’s compliance as assigned by the 2018 agreement.

It was damning!

Between July 2018 and June 2019, more than 12,000 people were placed in segregation in Ontario, and 46% of them had mental health alerts on their files. The Commission filed a contravention order in 2020 asking for a full prohibition on segregation for anyone with a mental health disability, a strict limit on any segregation placement beyond 15 continuous days and 60 total days in a year, and the creation of an independent monitor role to provide oversight of Ontario’s correctional system. I can find nothing since that date.

Getting back to the recommendations from the latest Faqiri hearing, the jury recommended that Ontario provide an independent watchdog with the power to launch investigations and to report annually. There were a total of 57 recommendations made but, as said earlier, there is no obligation to implement any of them. The archives are full of recommendations that have been ignored.

Hopefully, this time, some good will come of the needless death of a promising young man.

The Red Herring of Stigma – Part Two

By Dr David Laing Dawson

Stigma can be defined as “a set of negative and often unfair beliefs that a society or group of people have about something”.

‘Beliefs’ is the operative word here. When we are talking about the stigma of mental illness we are referring to the lingering effects of beliefs that date back hundreds of years, when it was commonly thought that mental illness, or the particularly odd, delusional behaviour of any one person, could be caused by that person having engaged in immoral behaviour, insufficiently honouring God, being in the throes of satanic worship, or actually housing the devil in some fashion.

Well, then the enlightenment came along, followed by science and modern medicine.

I assume in Canada today, few would ascribe to any of the beliefs in my second paragraph, but the attitudes may persist, with thoughts of immorality or devil possession being replaced by something like “weakness”, “not trying hard enough”.

How do we overcome these persistent attitudes? And are they really that important?

Our journey with cancer from 1950 to the present is instructive. Much of the stigma surrounding cancer has been conquered, subdued. But this did not happen because of Government or industry sponsored campaigns to diminish stigma. It did not happen because we promoted programs such as “Let’s Talk”, or “Moving Organ Health Forward”, invented new euphemisms like “cellular health issues”, or developed toll free hot lines for people to call if they were experiencing “cellular decline”. In fact, before about 1965, doctors did not use the word “cancer” in conversation with staff, families, and patients. Rather they used words of Latin and Greek origin that contained the soothing syllables of “neo” and “plasm”.

Today we talk openly of cancer. Cancer of various body parts, treatment of these cancers, treatment within institutions named “Cancer Centers”. As I have written before: Terry Fox did not run halfway across Canada to raise money for “Bone Health Issues.”

In contrast, with mental illnesses, we have been busy the past few decades developing new euphemisms, avoiding the words illness, mental illness, schizophrenia, psychosis, all in the mistaken belief that if we hide from reality, cover it up with gloss and good intentions, hide from it with privacy laws and secrecy, pretend that these illnesses are just extensions of “normal”, or expressions of “neurodiversity”, they will miraculously improve.

A unique experiment has been taking place in Canada the last few months. Instead of hiding behind shame, stigma, privacy, and euphemisms, one family has openly acknowledged, and publicly reached out for help, for an adult son and family member who is mentally ill, who suffers from a psychosis, and who became another homeless wanderer in Toronto. And it seems hundreds of people responded. Not with the fear and avoidance that stigma should engender, but with compassion, care, support. With good results so far, despite the failings of our mental health laws and faltering institutions.

So yes, “Lets Talk”, but lets talk reality, enlightened modern medicine, illness, and treatment of illness. Let’s name those illnesses and their symptoms. Without euphemisms and secrecy. Without pie in the sky “models”, without phony unscientific remedies.

And lets fund the professional resources needed to treat serious mental/brain illness, not just peer support, coffee urns in “crisis hubs”, three digit hot lines, and anti-stigma campaigns.

Mama Bear in PEI and the Red Herring of Stigma Part One

By Marvin Ross

Regular readers of this blog are quite familiar with the successful attempts by Marlene Bryenton of Charlottetown to rescue her son Andrew from the streets of Toronto where he lived for many months. Andrew suffers from a psychotic illness and spent many months wandering the streets of Toronto. Almost a year ago, because of his lack of insight into his illness which is not uncommon with psychosis, he stopped taking his medications and left home eventually ending up in Toronto.

He became one of thousands of people with untreated mental illness who had been left to fend for himself because of our refusal as a society to look after these sick souls. The difference for him was a tenacious mother who refused to give up. If you search this blog for “Bryenton”, you will find a number of blogs written by me or others who described why this happened and will continue to happen if our governments continue to refuse to help.

Today, Andrew is in hospital in Charlottetown and improving but his mother who refers to herself as Momma Bear is still concerned that his insight will not come back. Andrew still wants to stop taking his medication once discharged and to return to the streets of Toronto. Only two things will prevent that. The first is that he will be in hospital long enough to develop insight so that he will continue with his treatment upon discharge. That is not uncommon in many cases. The second is that he qualifies for a community treatment order (CTO) that will require him to continue with his medication for the right to live in the community.

His mother fought for a CTO for PEI which has not had one and it has been passed. Once it receives Royal Assent, it will take time for the regulations to be developed but, more importantly, it is deficient and Andrew will not qualify.

The PEI rule states that a patient needs at least 2 involuntary admissions AND a total of 30 days as involuntary inpatient. Andrew has only had one involuntary admission. Two of the leading experts in CTO’s (Dr Richard O’Reilly and Dr. John Gray) have suggested that the “AND ” be replaced by “OR” but it has been refused.

The rule in the neighbouring province of New Brunswick states that one admission of any duration OR none if there is a “pattern of behaviour” that is likely to cause serious harm or deterioration. Alberta has a similar provision to N.B.

PEI refuses to budge and so Marlene has another petition going across Canada to lobby for that change. See https://chng.it/MF2H48rszv

This is Marlene’s second petition. Her first which was successful was to arrange a ministerial order to have Andrew transferred from his hospital in Toronto to Charlottetown. As an aside, Andrew’s lengthy stay in that hospital came about from his mother’s fourth attempt to get him care. Four times she went to a Justice of the Peace to get a judicial order to have the police pick him up and take him to hospital for a psychiatric assessment. Three earlier attempts resulted in his being discharged between a few hours to the 72 hours required by law.

So, where does stigma enter into all this? If Marlene believed there was stigma towards those with mental illness and their families, she would have done nothing to help her son. She likely would have thought, what’s the use. No one understands and people are afraid of mental illness. But she didn’t do that. She plunged ahead and began posting on various facebook pages information about her son and his plight asking people to look for him and to let her know.

And people did just that looking out for Andrew, snapping a pic or taking a video and sending it to his mother. Likely thousands of them many of whom also approached him on the street with money, food, drinks and clothing. Where was the stigma the government and institutions tell us about? Now I don’t want to impute conspiracy into this but maybe if governments stopped with the stigma focus and used that money to provide the resources we need to help people, there wouldn’t be so many Andrews.

Bell’s Let’s Talk campaign devotes time, money and resources to talking about stigma which could be used to actually do something. As a country, we have far fewer hospital beds, psychiatrists, supported housing, community resources and disability allowances than most other 1^st world countries. Improvements to all of those issues is far more crucial than worrying about stigma.

A big part of that stigma comes from families of those who are ill so it is mostly self imposed. Maybe because we’ve all been told that stigma exists but, as I’ve discovered many times, most people have experience with mental illness and are very understanding and sympathetic. However, there are some families who do not speak out to health professionals because they have been ignored too often. The solution to that is to move your concerns up the bureaucratic ladder. No competent health professional should ignore family input.

Cancer and AIDS were also shrouded in secrecy but once people began talking about them, the situation improved. Those of us who have been impacted by serious mental illness in our families have to become more vocal for the sake of our family members and all who will come along in the future.

The Bryenton’s are showing us how to do that and we need to replicate their efforts.

Part Two from Dr. Dawson coming tomorrow. Stay tuned.

Health Research For What?

By Dr. David Laing Dawson

I have come to the conclusion that many if not most medical/behavioural researchers must be bitter souls. Whatever we humans like to do, they put under the microscope searching for reasons we shouldn’t do it. If we are having fun it is undoubtedly because we are doing something bad for our health.

Now many of us like our coffee in the morning. I prefer mine home roasted, Guatemalan Antigua. Two or three cups every morning. And I have been able to say, until recently, that whenever these bitter young researchers put coffee under the microscope they come away disappointed: for coffee appears to have in it, not just the seeds of pleasure, but substances that are good for our brain and cardiovascular system.

Of course that couldn’t last. Today in my news feed it appeared that coffee drinking, caffeine in particular, may be keeping us alert and focused, but it is also diminishing our neuroplasticity. That is, making it more difficult for us to learn new skills and concepts.

So I had to read the study. And, like many of these studies, it is flawed. Very small (tiny actually) cohort, unwarranted extrapolations from MRI data to real life, bent assumptions, biased conclusions. A waste of time and money.

But it did occur to me that thousands of young (and not so young) researchers, many as part of a degree program, spend millions of dollars researching questions that do not need to be answered, that flow from petty prejudices, that can’t be answered with small samples and poor methodology anyway, and that will ultimately have no effect on our welfare – well, actually, some of them do increase the number of self-deprecating jokes and moments of guilt as we continue to do what we must do. (From recent unnecessary research, while sipping pinot noir at a wine tasting in West Kelowna, I might make a comment about now knowing (“pointing to”, “suggesting”) the name of the ingredient in red wine that gives some people headaches.)

So let me propose to all those researchers, and the profs who mentor and support them, that we do this differently. We spend this public money differently.

The first step would be to survey old professionals. In medicine that would be old docs in many specialties, old nutritionists, old practicing dentists, judges, police officers….

And we ask each of them to formulate one question they would like answered, a question they know, if they had an answer, would actually help their practices, their patients and their clients.

The only time it would make sense to ask the question of coffee and neuroplasticity would be if experienced pediatricians and child psychiatrists noticed that a high proportion of autistic and OCD teens and young adults consumed coffee every day as children, and then wondered if, just maybe, coffee was the culprit.

Lets start there. Ask some old docs what questions went unanswered in their years of practice. Let that be the beginning of your research.

And remember Dr. Frederick Banting was 41 when he was allowed into a laboratory to seek answers to a question that he knew could, from his years of experience, make a big difference.

Guest Post – When love is not enough

By Lembi Buchanan

When I set out to write An Accidental Advocate, I did not realize how difficult it would be to share my own fears about violent behaviour associated with mental illness.

And yet, when my husband Jim encouraged me to write my memoir, he expected me to be completely honest about many of the challenges we have faced throughout our marriage. He wanted others to have a better insight into the complexities of bipolar disorder and its impact on families and friends. Not everyone understands the risks, certainly not the threat of suicide or even violent behaviour, when severe mental illness remains untreated.

Just the same, I worried about the stigma, that others might view Jim differently, and wonder if he might still be dangerous. I was also anxious about the impact on our children, Jonathan and Larissa since I had never mentioned that fateful encounter one morning when my world collapsed around me.

“Suddenly, Jim was on top of me, beating me with his bare hands. I shouted at him to stop and just as abruptly, he stopped, promising not to hit me anymore, if I stayed in bed. I’ll never forget the distant look on his face. I was terrified, lying there in a state of shock. One day, Jim was deliriously happy about our relationship telling me that I was the best thing that ever happened to him. The next day, he was suspicious of my motives, angry and threatening. Without warning, Jim violently assaulted me for no reason at all. At least, that’s what I thought.”

While I lay trembling under the covers, Jim packed up some of his belongings into a box and left the apartment. Although I was terrified that he might return, it never occurred to me to call the police. Instead, I called the locksmith.

I learned several weeks later that Jim had been listening to secret codes and messages over the radio, night after night, when I was asleep. The auditory hallucinations were very real, sending him on an important mission to save the world. He simply could not afford to take any chances, that I might try to stop him.

While most people living with a mental illness are not dangerous, some, if they are experiencing psychotic symptoms, may assault, and even kill those they love.

I was one of the lucky ones.

Carrie Costello, who lived in the upscale village of Hastings-on-Hudson in New York State with her fiancé Michael Lauder, was not as fortunate. On June 17, 1998, he fatally stabbed the woman he loved because he thought she was a wind-up doll intent on torturing and killing him. Michael had been diagnosed with schizophrenia when he was 24 years old and hospitalized in a psychiatric ward for eight months before entering Yale Law School and graduating summa cum laude. Referring to himself as a “flaming schizophrenic,” Michael sold movie rights to his story and was working on his autobiography prior to the tragic consequences when he stopped taking his meds. Michael was found “not guilty by reason of mental defect.” He resides at the Mid-Hudson Forensic Psychiatric Center to this day. His best friend, Jonathan Rosen tells the story in his recently published The Best Minds: A Story of Friendship, Madness, and the Tragedy of Good Intentions. 

We even have a term for these crimes, calling it “intimate partner violence.”

A Statistics Canada report, “Homicide in Canada 2020,” noted that there were 743 homicides that year. Police suspected the presence of a mental or developmental disorder in 20 per cent of persons accused of murder. Over half (56%) of these homicides were committed against a spouse or family member.

In the early morning of October 23rd, 2023, there were five lives lost in a murder-suicide tragedy in Sault Ste. Marie, Ontario. Although we have no information about the mental state of the man who did the shooting, surely, it was not the actions of a sane person to kill members of his own family, including three children.

Many of these tragedies can be prevented if people living with a severe mental illness get the help they need, when they need it. Fortunately for Jim, he was discovered only hours after assaulting me, on the roof of St. Patrick’s Cathedral in New York City waiting for a helicopter to take him to God. Instead, the police took him to the hospital where he was treated for his psychotic symptoms.

What could be simpler than providing evidence-based medications to treat a severe mental illness?

Bipolar disorder and schizophrenia, can be dangerous and deadly brain diseases, if left untreated. These are complex biogenetic medical conditions where heredity plays a major role in the lottery of life. And yet, anti-psychiatry activists and civil libertarians continue to reject advances in neuroscience as well as indisputable evidence of the efficacy of mood stabilizers and other drugs to treat the symptoms of these complex biogenetic medical conditions. They fail to appreciate how disabling a severe mental illness can be. Instead, they profess that involuntary hospitalization and coercive treatment are crimes against humanity.

Just as distressing are some of the claims made by leading voices on mental health and addictions, denying the genetic basis for bipolar disorder, including Canadian physician and author, Dr. Gabor Maté. In his new book The Myth of Normal, co-authored with his son Daniel Maté, he refutes the biological approach to mental illness, which he refers to as a “construct,” as if it is an abstract concept. Dr. Maté questions the imbalance of DNA-dictated brain chemicals as the cause of severe mental illness when he refers to psychologist Dr. Kay Redfield Jamison’s recollections of a manic episode in her memoir An Unquiet Mind. Dr. Maté makes a reference to her “faulty assumptions that exemplify the simplistic genetic narrative to which psychiatry still clings.” He also notes that “these assumptions are highly questionable and limit our understanding. Worse, they generate harm, both in the sense that they leave many people subjected to inappropriate treatments and in that they displace perspectives that could be far more complete, humane, and helpful.”

Instead of accepting the biological bases of severe mental illness, Dr. Maté claims that one of the main causes, not only of bipolar disorder but also other diseases, MS and ALS, even cancer, is childhood trauma. During a speaking engagement in London, England last year celebrating the launch of The Myth of Normal, Dr. Maté referenced a study of women, who have been sexually abused as children, as having a high risk of developing endometriosis. However, his hypothesis doesn’t explain my diagnosis, when I was 45 years old, of a very rare form of uterine cancer, endometrial stromal sarcoma.

There was no evidence of childhood trauma in my life, or Jim’s for that matter, as the cause of our illnesses. Fortunately, pharmacological treatments have prevented a recurrence of symptoms giving both of us a new lease on life. And we continue to take the drugs we need to stay the course.

Government policy and decision makers may see the value of adopting models of patient empowerment and peer support to make the most of scarce mental health dollars. And yet, relying on a do-it-yourself approach is not a substitute for specialized psychiatric services required by persons impaired by delusional thoughts, many of them living on our streets, unaware that they are ill.

Others, like Jim and Michael, were never candidates for compassionate and accessible voluntary services and supports in the community. They grew up in privileged homes and managed to mask their symptoms even when experiencing paranoid delusions. No one suspected, not even their own family members, that they were capable of harming the people they loved. I escaped with some bruises while Carrie, who was pregnant with their child when Michael stabbed her with a chef’s knife, became a statistic.

Whether we like to admit it or not, there is an elevated risk of violence among people experiencing psychosis. The numbers may be small but the outcome is always tragic, especially when it is preventable.

We need the political will to treat severe mental illness with the same urgency as physical diseases.

We need to provide an adequate number of psychiatric beds to enable all individuals to receive the care they need before they become candidates for involuntary admission or worse, end up in the criminal justice system.

Lembi Buchanan lives in Victoria, BC and has been fighting with the Canadian Revenue Service for years to get tax fairness for those with mental disabilities. She  is the recipient of the Meritorious Service Medal for her advocacy work by His Excellency, the Right Honourable David Johnston on March 4, 2016. She has also received numerous other awards, including the Queen’s Jubilee Medal in October 2002 and the City of Toronto Access Award for Disability Issues in December 2001