I overslept, so I missed church again. I need to try to get to bed earlier, but it's hard. I woke up with a rash around my neck, which I assume is a heat rash, as I've been getting those in the inside of my elbow sometimes recently, but never on my neck.
I found out yesterday (via mail) that the Vocational Rehabilitation people classified me in group II, which is the second most disabled group. Last time I, before I lost my last job which landed me up north with my brother because of resultant lack of income, I was in group I. I'm not as disabled as I was then, but now I have more health maintenance things I have to do for conditions, if properly maintained, shouldn't be too problematic. But if I stop the health maintenance things for most of them my health would deteriorate significantly. It's sort of a catch-22; I'm not as disabled as long as I keep up with these things that take more time, which in itself is emotionally discouraging (who wants to spend so much of their time - and money - on health?), but if I free myself up and for whatever reason stop doing some of these things, I might be able to do more because of having more time and money (and not having to deal with the psychological aspects of having to spend so much time and money on health maintenance) my health will subsequently deteriorate.
All the health maintenance things are a large part of why I don't think I could work more than part-time, which would continue to keep me dependent on SSDI because of the health insurance issue, because of all those other constraints on my time when my health isn't optimum no matter how you look at it.
Still, I think I'm reaching a point where I could work part-time now. But being classified as second tier disabled by V.R. means I'll have to wait longer to actually move on to the next step, which is developing a work plan with them and actually gaining their assistance. I've gone through the application process, and now I have to wait for an opening to come up so I can actually get their assistance; this waiting is because the state doesn't have enough money budgeted for dealing with all applicants as they apply and are deemed eligible.
To seriously look for work, though, I would like to have assistance because of the delicacy of working around SSDI. Since I don't know when I'll actually be able to start getting assistance from the state (V.R.), I should probably call the large legal firm that handled my SSDI hearing appeal. They have a system set up where they can help with this kind of thing, although I'm not sure exactly what they'll be able to do. I imaging it entails some kind of legal counseling regarding working around the SSDI situation. I hope to find out for sure this week though.
I still don't have money to pay my co-pay to get in to the allergy doctor for tomorrow's re-scheduled appointment (it was re-scheduled from last Monday because I didn't have the money then either). I would really like to start on allergy immunization, which the doctor said he intended to do. That would at least address one issue, and anyone who has multiple conditions can understand how there's sort of a compound effect when you start adding conditions on top of each other, and as a result dealing with even one condition can have more positive impact than you'd expect if just dealing with the one condition by itself. This is especially true when one conditions is something like fibromyalgia which can be aggravated by other things going on in the body.
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Chapter 5 of The Taming of the Troops is titled "Psychiatry in War and Peace".
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"There are, of course, many soldiers who are not controlled by the collective techniques analyzed in the last three chapters. These men are processed by a variety of deviance-controlling sectors, including military psychiatry, the military justice system, and military prisons...
... The balance between expulsion (through discharges or incarcerations) and resocialization (or therapy) depends on the manpower needs of the Army... I will argue that psychiatrists in garrison situations as well as those who deal with combat neuropsychiatric casualties have a strong tendency to define as ill as few soldiers as possible so the Army will not lose manpower." (p. 157)
First of all, I really don't like the word "control" as it's used here, although I'm sure it's appropriately used. Control brings up images of total institutions and authoritarian organizations.
Control through military psychiatry, however - if control is the proper term vis a vis "military psychiatry" brings up images of Soviet abuses of psychiatry. After all, wasn't the Soviet Union's purpose "deviance-control"?
Now clearly (?) there is a distinction between the chaplaincy and psychiatry, even in the military, but there certainly is some overlap, don't you think? After all, most pastoral training programs (Th.M. programs, for example) include at least one class on parishioner counseling or psychology, right? And pastors do do some kind of counseling, although the more serious cases would be properly referred to professional psychologist. I did find a file (a rather thick file) on military chaplaincy, but I haven't reviewed it yet, so I'm not sure exactly what's in it. But I wouldn't be surprised if chaplains in the Army might find themselves somehow in similar positions as in civilian settings, so they probably have to have to at least be part of the adjunct participants in military psychiatry. So I'm going to assume in this chapter that military chaplains aren't unfamiliar with the kinds of things discussed here and are even at least passive accomplices in military psychiatry.
The other thing in this passage is that it's not ultimately the condition of the soldier but the needs of the army that determine his treatment schedule. Is this consistent with the Hippocratic oath?
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"Why would a psychiatrist succumb to these organizational pressures?...
To begin with, the structure of the psychiatrist's tasks makes long-term therapy impossible. The army places so many demands on a psychiatrist's time that he cannot function in the therapy role for which he may have been trained as a civilian." (p. 157)
The text goes on to explain demands on the soldier's and the psychiatrist's time, and also how either party being transferred can disrupt the continuity. This doesn't apply to the Vienna situation.
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"Another source of difficulty is the fact that military psychiatrists do not enjoy the close relationship with their patients that most civilian psychiatrists do. Their communications are not privileged, and what a soldier tells a psychiatrist may be held against him in court. For example, during the Vietnam War many symptoms that soldiers complained of were related to combat violence and atrocities or violent attitudes toward superior officers. If a soldier went to a psychiatrist to talk about his problems, one of two conditions would have to prevail for psychotherapy to continue: either the psychiatrist would have to (illegally) tell the soldier he would not reveal or record anything that occurred in interviews, or the soldier would have to withhold his 'illegal' thoughts or acts from his conversation with the psychiatrist." (p. 158)
One thing here that might apply to Vienna, is that if the military chaplain/h.r. director was playing a counseling-type role (which was also one style of relating between boss-secretary), then the HIPAA-type privacy constraints of a counselor-counselee would not have been in effect, any more than it would have been in the boss-secretary relationship. That is, I think those in the higher positions discussed these kinds of things and others were fed tidbits as deemed appropriate, such as for "control" purpose. This kind of thing would be hard to prove, though, unless I had kept detailed journals of my experiences there that could have pointed to things that were said by people who couldn't otherwise have known the specific thing about me that was revealed. For example, if I'd told my boss about something and he was the only one I told, and later another secretary gave me indication to believe that she must know about it. I hope you can see how if this was indeed happening it would be very hard to trust anyone who might be part of that, and also how any information revealed could be used to sort of tow you in.
In Vienna the "'illegal' thoughts or acts" would have included anything involving serious questioning of the organization and also anything that might "blow their cover" or be what they perceived to be a potential risk to them. Since 1) I had a lot of questions about their modus operandi and the underlining assumptions that must accompany them and 2) I was sort of a loose cannon, there were a lot of things I didn't want to talk with them about, and which was why I didn't keep a journal - although I couldn't have expressed it as succinctly as I am now. But I was very cognizant, nonetheless, even at the time of there being things I could not reveal about my thoughts. This could, of course, make me look very paranoid unless there was some justification for these fears. However, my contention is that I wasn't any more paranoid than the soldier who withheld his "'illegal' thoughts or acts from his conversation with the psychiatrist." But in my case, it wasn't just the psychiatrist. It was like living in Romania under the crazy man Ceausescu who just seemed to repress everybody but not in a consistent or otherwise logical way. In Romania, where the churches were growing at a phenomenal rate, the authorities managed to pretty well divide the church against itself as no one trusted anyone else because of the seemingly all-pervasive monitoring system of informants and the like. As far as I was concerned, the whole of the mission organization was one big informant, all committed to the cause, not questioning the organization's basic underlying tenets and ready to protect the mother ship on a dime. Or maybe the illustration of being alone on a tiny raft in the middle of the ocean, away from friends and family, surrounded by sharks helps you appreciate what it was like. One wrong step and I would be toast... dinner so-to-speak, in shark terms. I was not at all convinced they had my best interests at heart, but I suppose some would say that they did and I mistakenly identified them, when they were really harmless dolphins.
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"During the Vietnam War with the accompanying widespread anti-war sentiment among soldiers, how would a liberal, anti-war psychiatrist have resolved the role conflicts inherent in his position as an 'internal pacification officer'? Thee are probably as many resolutions as there are psychiatrists, but I think the response of one politically liberal psychiatrist is instructive. In 1970, I asked him if he would support resisters in the Army. Surprisingly, he said it never was a problem for him because he did not think there were any. This psychiatrist, however, held rather narrow standards of what constituted resistance; to him, a definition seemed to require a commitment to pacifism or some other 'ism' and therefore had to be articulated, explained, and maybe even justified in philosophical terms. His view restricts the term resistance to those who can speak in middle-class terms, particularly college-educated terms." (p. 158-159)
In my case the situation would have been more difficult, because, although I was college-educated, it wasn't just a situation of war and peace, but trying to make sense of something you were in the middle of that didn't seem right but was hard to make out - which is why I had to do all this research resulting in me having these texts to discuss now.
Like the psychiatrist described in this passage, however, I don't think the people in Vienna knew how much I was questioning them, although one person especially near the end of my time there repeatedly told me something that made me think they did think I was not completely conforming. I'll get to that in my chronological account, however.
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"Daniels argues that military psychiatrists' definition of what constitutes mental illness has adapted to the organizational needs of the military. As a result, there is a tendency to stress adjustment rather than introspection or self-awareness. There is also a tendency to view adaptability as both a voluntary act of the soldier and a result of psychiatrist's denial of symptoms." (p. 160).
If we take this at face value and apply it to my Vienna experience (assuming, for example, that the military chaplains on staff had also been privy to this kind of thinking in their military experience and succumbed to it, then anyone who exhibited what could be psychiatric distress of one kind or another would be similar, namely, to help the troubled staff (or family) member would be encouraged to learn to adjust to live in the Vienna mission context. In my mind, this defines the problem as being one involving contextual problems - problems adjusting to Army life, or, in my case, problems adjusting to the life in the Vienna mission, rather than primarily internal problems.
Now, I'm not a psychiatrist, not even close, but my understanding of the human being is that while there are many different parts (physically or otherwise) to the person, all the parts are very closely interconnected and cannot always be readily and easily disentangled. This seems to me to be a situation where that could be the case, where the context, the relationship of the individual to the context and the individual apart from the context, could all come into play. My contention is that without a little investigation into the matter, it would often, or at least at times, be hard to quickly discern which aspect needs addressing.
It sounds to me like these psychiatrists determine fairly quickly that the situation is relational (between the person and context) and not particularly personally internal (psychological). Upon making that determination the psychiatrist then furthermore assumes that the soldier, the individual, is otherwise internally/psychologically healthy and is capable of surmounting these relational problems on his own without professional health. If I'm right, this sounds like a lot of assuming to me.
Nevertheless, we need to bring this back to Vienna. If the military chaplains in Vienna (who may or may not have been "infected" with this kind of military thinking) were to follow this line of thinking, would it result in something akin to my experiences in Vienna? The answer, I'm afraid has to be a pretty sound "no."
The kind of thinking described here is looking out for the host institution's (military's or Vienna mission's) apparent best interests in trying to keep as many soldiers as possible in circulation in a situation where manpower is needed and not easy to replace. There are several things here that don't fit the Vienna situation. First of all, I think I mentioned elsewhere that I developed a sense that no one was indispensable and also that I often had little work to do, and as such the manpower restraint would appear to not be a significant consideration in the Vienna context.
But also, if this were the case, our Vienna military chaplain (one of them in particular) would have done everything he could have to avoid taking me out of circulation, even temporarily, right? Wrong. This did not happen.
I will say, however, that although these combinations of assumptions don't fit the Vienna context, individual components taken separately do. That is, I find it hard to believe that they (not just the military chaplain) really had my interest at heart and indeed primarily had the mission's interests at heart, or maybe even the U.S's best interests at heart if this involved an indirect attempt to get me out of ministry to that part of the world in order to protect my dad and information he would have had access to. This is all hypothetical here, but I'm just laying these theories out as possibilities to be tested, in as much as is possible at this point in the game.
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Here's a direct continuation from the previous quote:
"This approach to mental disorders is transmitted to individual line officers. Some of my interviewees have asserted that their commanding officers refer soldiers whom they do not know how to handle ('troublemakers,' for example) to the psychiatrist. The psychiatrist typically will simply send them back to their unit after minimal counseling. Some psychiatrists tell commanding officers not to refer them any mental cases unless they want to (1) discharge the soldier under AR 635-212 (unfitness and unsuitability) or 635-89 (homosexuality), or (2) court-martial him and require certification of sanity, or (3) evaluate him for security clearance. In this manner, psychiatrists and line officers can cooperate in denying illness (and treatment) except in those cases where they want to get rid of the soldier." (p. 161)
First of all, if line officers are privy to this approach to "mental disorders" I would be pretty surprised if military chaplains weren't also, and even a part of this approach to mental health and the soldier.
Secondly, I'm going to look at these numbered items in reference to the Vienna mission to see if they shed any light on how things were done in the Vienna mission, and my experiences in particular.
The second item hardly implies, and certainly not in a legal sense as in the Army. The only possible corollary I can think of with the Vienna mission would be if it were suspected that there was a spy, a plant, or something along those lines in their midst. If they could prove the ill intentions of the person they could have person expelled, which they would easily have had the right to do under such circumstances. How hard could it have been to convince, given sufficient evidence, the supporters and churches back home (not to mention the mission's governing board of directors) that the person was being expelled for being an informant, or whatever the exact determination was? In fact, this kind of think would undoubtedly serve to loosen any possible accountability leash that might have existed even more so that they could strengthen security measures, which, of course, would probably mean more secrecy. The possibility of this happening or ever having happened was very small, very close to nil, I think. I'm not just talking about someone walking in the door as a visitor or repair person (for example), but about someone who was one of "them".
The first case, being referred patients as being potentially either unfit or homosexual, is more of a possibility, however. In this case, the Vienna mission might have doubted whether I was really fit to work with them, if I was emotionally stable enough to withstand the stresses of their work and how they carried it out. I find this a reasonable possibility. If it were indeed the case, they should have made every effort to see to it such a person in question was treated and restored to functionality if at all reasonably possible. So we'll keep this option in mind regarding how they might have operated and how they treated me in particular.
The third and last case given here, namely to be evaluated for a security clearance, doesn't exactly apply to the Vienna context, in as much as "security clearances," in the standard sense of the word, were not issued for that work. However, that being said, the work did involve security issues and the mission as a whole and individual colleagues in particular had to be able to trust each individual in the organization to be able to withstand the stresses that would possibly apply to their particular positions, duties and responsibilities within the organization. It could be, then that psychological-type processes (we didn't actually have a psychiatrist on staff that I'm aware of) were used in this process and that anyone with questionable emotional stability could have been referred for professional help to assist in making this determination. But since they didn't have a psychiatrist on staff and it might raise some questions or even eyebrows back home if it were known that psychiatry were used in this manner, they would have probably had to do this indirectly. That is, the psychiatrist might well not have known what the precursor was to the person's coming to him/her for help regarding institutional experiences and demands, which were, of course, secret and meant to be kept secret. In this case the person would go to counseling and manage to resolve any of his/her problems that might exist without mention of the "secret" aspects which would make him/her look paranoid or worse anyway, because who would believe such nonsense? So if the person on the receiving end of this treatment were to spill the beans and be open and frank about everything, that person would be found to have some serious mental illness and their testimony to these things would then be tainted as coming from a person who had serious mental problems, right? Or the person could avoid mentioning the "secrets" but internally not resolve the conflict of knowing what s/he had to do to overcome the conflict, and since the conflict inside remained there were signs of emotional disturbance, none of which pointed to the mission, because these things were kept "secret". So these are the options that I'm suggesting here is the security clearance case were a possibility:
1) The person resolves the internal conflicts vis a vis self vs. the mission and comes out clean and healthy
2) The person spills the beans about everything going on in the Vienna mission that is disturbing him/her in direct conflict with his/her beliefs and expectations about how things should be, and is deemed crazy, thus an unreliable witness
3) The person does not spill the beans but also does not resolve the internal conflict, thus resulting in emotional instability apparently not directly related to his/her experiences in Vienna.
4) I'll add this one here, for the sake of completeness: the person is actually mentally unstable, apart from anything particularly connected to Vienna, except maybe as that experience's being the proverbial straw that broke the camel's back. In this case, one would think (speaking as a layperson here) that the person would exhibit signs of mental instability throughout his/her life, which may or may not have surfaced before the relationship with the Vienna mission.
If there are other options, I am not omitting them intentionally.
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I need to take a break and do some things at home, but I'll be back to discuss this more later.
~ Meg
