ARE YOU MAD?

Dr. Fred Hickling has char­ac­ter­ized the Jamaican soci­ety large­ly as mad. This assess­ment drew howls of con­dem­na­tion from many Jamaicans who weren’t too keen on being char­ac­ter­ized as mad . There was also the pletho­ra of high­fa­lutin  the­sis’ writ­ten, that makes sense only to the writ­ers , all in con­dem­na­tion of Dr. Hickling.

As a lay per­son , not sure whether I am mad or not, I was quite pre­pared to let the two sides of the mad debate duke it out ‚Hopefully the peo­ple who feel we are not real­ly all mad, would win the debate , that I could take back to my wife and say ha ha, see I told you I was not mad! She some­times tries to con­vince me I am a crazy Jamaican. She thinks the mad­ness did not get passed down to her, despite the fact her par­ents are Jamaicans. She was born in the United States, so she gets to dis­par­age me as a crazy Jamaican, while rev­el­ling in the good Jamaican val­ues her par­ents impart­ed into her. I keep telling her that the two are an oxy­moron, she disagrees.

Anyway after real­ly look­ing at what is hap­pen­ing in Jamaica I might have to admit I’m not sure what to think, absent any oth­er expla­na­tion, I’m sure this will invoke a lot of crow­ing from the wife , but there may be no way around it. Seriously though let’s take a look at some of what Dr. Hickling said.

Professor Fredrick Hickling and clin­i­cal psy­chol­o­gist Vanessa Paisley have con­clud­ed that per­son­al­i­ty dis­or­der is preva­lent in Jamaica.Their find­ing is con­tained in a sci­en­tif­ic paper pre­pared for pre­sen­ta­tion at the Society for the Study of Psychiatry and Culture in Seattle, Washington, in June. The paper is titled ‘Population Prevalence of Personality Disorder in Jamaica’. some­thing is wrong . According to Professor Hickling, a per­son would be char­ac­terised as hav­ing a per­son­al­i­ty dis­or­der if he or she is show­ing signs of a com­bi­na­tion of the fol­low­ing fac­tors: pow­er-man­age­ment strug­gles, psy­cho­sex­u­al dys­func­tion, and depen­den­cy issues​.Data from the four-stage, strat­i­fied ran­dom-sam­pling method, sug­gest that the rate of per­son­al­i­ty dis­or­der — approx­i­mate­ly 40 per cent — in the Jamaican pop­u­la­tion is marked­ly high­er than the inter­na­tion­al­ly iden­ti­fied rate of six-15 per cent. “We have to recog­nise that some­thing is wrong and not brush things under the car­pet,” said Paisley.The sci­en­tif­ic sam­pling was car­ried out by Don Anderson & Associates on a rep­re­sen­ta­tive pop­u­la­tion sam­ple of 1,506 Jamaicans age 18 to 64 years. Extrapolation of the data reveals that near­ly one mil­lion per­sons in Jamaica suf­fer from per­son­al­i­ty disorders.Hickling and Paisley believe the find­ings could explain the high risk of behav­iour­al dys­func­tion in the Jamaican population.“Extrapolating these find­ings to our soci­ety, there is no won­der about the high rates of mur­der and vio­lence, rape, and oth­er sex­u­al atroc­i­ties, and crimes such as theft and prae­di­al lar­ce­ny that are crip­pling our soci­ety,” the aca­d­e­mics not­ed in a joint let­ter to The Gleaner pub­lished ear­li­er this month.According to Hickling, if the find­ings don’t influ­ence pub­lic pol­i­cy, “then we are doomed to repeat­ing the same mis­takes of the last 100 years or since Independence”.He is con­vinced that many of the crime strate­gies employed by the secu­ri­ty forces have failed because this sci­en­tif­ic aspect of the crime prob­lem has gone unad­dressed. “Introspection and leg­is­la­tion will not solve this prob­lem. We will con­tin­ue to fail,” Hickling said.Paisley agrees. “We have a fail­ure in our men­tal-health pro­vi­sion. It is hin­der­ing our abil­i­ty to move forward.“Policies should be geared towards the train­ing of prac­ti­tion­ers and imple­men­ta­tion of effec­tive psy­chother­a­peu­tic moda-lities that can be used to treat per­sons with the disorder.“Proper screen­ing meth­ods should be imple­ment­ed in men­tal health treat­ment facil­i­ties, includ­ing screen­ing of per­sons in sub­stance-abuse facil­i­ties,” she added.

des­tig­ma­ti­sa­tion

Paisley also argued that pub­lic-edu­ca­tion pro­grammes util­is­ing all forms of media should be used to enlight­en the pub­lic about the var­i­ous men­tal-health issues that are preva­lent in the soci­ety and the treat­ment options that are available.“Campaigns should also push to fur­ther pro­mote the des­tig-mati­sa­tion of men­tal ill­ness in Jamaica,” Paisley said.Hickling point­ed to the Cuban and Singaporean exam­ples. “Cuba has imple­ment­ed behav­iour-mod­i­fi­ca­tion tech­niques. Many of them are said to be dra­con­ian. People are crit­i­cal of the Cuban mod­el, but it is effec​tive​.In Singapore, if you spit on the street, you are locked up and put into a behav­iour-mod­i­fi­ca­tion programme.“However, in Jamaica, “the crime plans we have ‚catch a small num­ber of peo­ple and many of them get away,” said Hickling.The pro­fes­sor believes behav­iour-mod­i­fi­ca­tion pro­grammes, crime plans, and leg­isla­tive issues need to go hand-in-hand if Jamaica is to tame the crime mon­ster. “The sever­i­ty of treat­ment and leg­isla­tive pro­gramme needs to be depen­dent upon the sever­i­ty of the prob­lem and the lev­els of the peo­ple who are man­i­fest­ing the prob­lems,” he said.Hickling and Paisley’s find­ings have already attract­ed crit­ics who have sought to dis­cred­it the find­ings. But Hickling has some choice words for his detrac­tors: “Of course they would dis­agree because they know noth­ing about it. If you throw stone in a hog pen, the first one who squeals is the one who gets hit. The peo­ple fight­ing against it are not clin­i­cians; they haven’t done the work.“In this whole busi­ness of men­tal ill­ness, it is the one who it lick is the one who squeals,” said Hickling.tyrone.​reid@​gleanerjm.​com

Treatment

Hickling said per­son­al­i­ty dis­or­der can­not be treat­ed with med­ica­tion, but treat­ment can­not be ful­ly explored until the coun­try accepts that some­thing is wrong.“There are two ways to stop it (per­son­al­i­ty dis­or­der): by pre­vent­ing young peo­ple from devel­op­ing it, and old­er peo­ple from get­ting worse with the use of behav­iour-mod­i­fi­ca­tion psychotherapy.”

Severity Ratings

Mild Personality Disorder

The per­son knows some­thing is wrong with his or her behav­iour and usu­al­ly seeks help.

Moderate Personality Disorder

This is when you can look at some­one and say there is some­thing wrong with his or her behav­iour. Excessive drinkers, smok­ers and eaters, etc, usu­al­ly fall with­in this cat­e­go­ry. But they are per­son­al­ly unaware of the fact that they have a problem.

Severe Personality Disorder

This cat­e­go­ry is much eas­i­er to spot. Persons who have con­tin­u­ous run-ins with author­i­ty and author­i­ty struc­tures fall with­in this group.

Some symp­toms

Person con­sis­tent­ly has pow­er-man­age­ment problems

Psychosexual prob­lems (mul­ti­ple sex­u­al part­ners, sex­u­al dys­func­tion, abnor­mal sex­u­al prac­tices, etc)

Dependency prob­lems.(cour­tesy Jamaica Gleaner​.com)

Proffesor Hickling’s ass­es­ment aside , the rea­son I write this blog is this, are we real­ly mad despite the neg­a­tive con­no­ca­tion ?,and if we are what are the real rea­sons we are trau­ma­tized to this degree? Or, are we just look­ing for an excuse to avoid avoid fac­ing the dis­func­tion. Let’s face it every day there are more and more evi­dence in the news that would tend to sup­port Dr’s. Hicklings and Paisley’s ass­es­ment. I know it is not a sub­ject we Jamaicans are com­fort­able talk­ing about, but the argu­ments both proffe­sion­als make, seem to have a lot of weight in light of what we see hap­pen­ing today in our society.

Proffesor Hickling did not mince words when he respond­ed to crit­ics of the ass­es­ment he and Dr Paisley made quote: “Of course they would dis­agree because they know noth­ing about it. If you throw stone in a hog pen, the first one who squeals is the one who gets hit. The peo­ple fight­ing against it are not clin­i­cians; they haven’t done the work.“In this whole busi­ness of men­tal ill­ness, it is the one who it lick is the one who squeals” . I find Proffesor Hicklins response refresh­ing and unpre­ten­tious, he actu­al­ly summed up the cadre of high­fa­lutin elit­ists that I allud­ed to ear­li­er in this blog, with­out being high­fa­lutin him­self. In essence Proffesor Hickling spoke to the Academics, and the wannabes , but was also able to reach the com­mon man. There was an absence of pre­tence and grandios­i­ty which as a lay per­son I found quite refreshing.

One of the Really inter­est­ing points of note evi­denced here, is the abil­i­ty of Jamaicans to pre­tend, we pre­tend that Jamaica is nice, while we hide behind lay­ers and lay­ers of iron bars in our own homes.

We pre­tend Jamaica nice while peo­ple are being decap­i­tat­ed. Our rea­son­ing? Well those peo­ple did some­thing to people, .

Question is: How long will it be before you do some­thing to some­one and lose your head ?

We pre­tend Jamaica nice while extor­tion­ist suck the life out of the finan­cial sec­tor , using the mon­ey to pur­chase guns and ammu­ni­tion to keep us more enslaved .

Our ratio­nal­iza­tion: Well the busi­ness peo­ple were mak­ing a lot of mon­ey and was­n’t giv­ing any­thing back​.No mat­ter what is going on we pre­tend that as long as it’s has­n’t touched us it does not exist, or it isn’t as bad as oth­ers say it is.

We have fol­lowed this course of denial to what now seem to be the brink of the precipice. Our friends from uptown , not nec­es­sar­i­ly the old monied inter­ests , but the john­ny come late­ly are the mas­ters of this, they are the most pre­ten­tious, these are usu­al­ly black social climbers who have gained some edu­ca­tion ‚and wants their piece of the Aristocracy.

They are worse than the left over mulat­toes from yester-year, who gen­er­al­ly are more rea­soned, those who hap­pen to fall with­in the group char­ac­ter­ized as old cap­i­tal­ists are lit­er­al­ly marked for death (Douglas Manley for­mer health min­is­ter and broth­er of for­mer Prime Minister Manley can relate to that, he was not spared hav­ing his pri­va­cy invad­ed , his broth­er helped to cre­ate that men­tal­i­ty).

The john­ny come late­ly are to be found in all stra­ta of the soci­ety , media, legal fraternity,medical fra­ter­ni­ty, busi­ness, NGO’s and even with­in the church , as we all know at the head of that pack are the polit­i­cal class. These are the ones who shape pub­lic opin­ion, which is real­ly not hard to do in Jamaica if you have a lit­tle money,.They use the media , their pul­pits, and oth­er medi­ums to push their agen­das, mak­ing our coun­try their fief­dom and the mass­es their serfs.

So as we strug­gle with this state of con­tem­pla­tion of whether we are mad as Dr. Hickling et al said , I hope that it will be set­tled that we are not mad ‚maybe just dys­func­tion­al, but hon­est­ly I do see at least one of the signs the good­ly Doctors point­ed to in myself.

I hate it when my wife is right.

mike beck­les:

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