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Rally, the Excellence blog, gives voice to issues, ideas and news in mental health recovery

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October 14, 2014 by Sandra Steingard, MD

Rethinking Psychiatry

FilmFestivalI was honored to both attend and participate in the recent Mad In America Film Festival. I was one of three psychiatrists who were asked to respond to the themes and questions explored in the festival. What follows is a lightly edited version of my remarks.

First of all, I want to thank Laura Delano for inviting me. She is a woman of great fortitude and bravery.

I also want to thank Robert Whitaker, our moderator and the inspiration for this festival. I first wrote to Bob on May 29, 2011. I had never written to an author before. I went back to look at the first of a long and ongoing correspondence. This is how I concluded that first e-mail:

“I am almost immobilized at this point.”

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October 13, 2014 by Phil Borges

CRAZYWISE: A documentary Film Directed by Phil Borges and Kevin Tomlinson

ThuptenA 20-year fascination with shamanism leads photographer and filmmaker Phil Borges to question how Western cultures define and treat severe mental disorders. CRAZYWISE is a feature documentary centering around Adam Gentry, a young man struggling with his sanity while trying to understand his diagnosis and cope with the many pharmaceutical combinations prescribed to him. In-depth interviews with renowned mental health professionals, anthropologists and survivors reveal insights on the nature of mental illness and how a new survivor-led movement is challenging a mental health system in crisis.

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October 10, 2014 by Kathy Brous

Stephen Porges on Treating Trauma and Compassion

Stephen Porges magesDr. Stephen Porges discovered in 1994 that trauma in humans comes from our most ancient “reptilian” freeze reflex. He calls it the Polyvagal Theory, as I wrote last week. But Porges also says we can use our mammalian attachment system to heal this.

This week I have a few short (and two long) Porges videos to share with you, which since Polyvagal is pretty darn complex, are really wonderful to have.

I really like “The Science of Compassion,” his talk at the Stanford University conference of the same name.  Here they are:

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October 6, 2014 by Oryx Cohen, MPA

Wellness Is a Journey

As someone who takes language very seriously, recovery is a bit of an interesting word.  A dictionary definition of recovery suggests that one is recovering back to a previous healthier state of being.  However, many people do not have much to recover back to, as their lives have been filled with mostly horror.  And then there are those of us who don’t believe we are recovering from anything, that our altered states and emotional distress are just a part of being human.

I think when we use the word recovery now we are actually creating our own definition that looks more like a wellness journey.  The great thing about focusing more on wellness is that wellness applies to all human beings.  It is my belief that altered states and emotional distress are human experiences, and we have a lot to learn from them about what it takes to stay well as a society.  The following poem I wrote in response to a person with lived experience who did not believe that “recovery” is real.  I’m happy to say she believes in recovery now.

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October 6, 2014 by Fran Silvestri, MBA

Meet the Board: Chair Fran Silvestri, MBA

When I was asked to join the board, the potential impact of The Foundation for Excellence in Mental Health Care to radically improve how we support people in distress was easy to see.  EXCELLENCE is unique both in the U.S. and globally. Even  now, we are germinating the next generation of supports and system improvement that will allow all people in distress to manage their lives, enjoy their families and friends and be included in all community and social networks where we work and play.

There are myriad, time-consuming debates about what isn’t working. While important to consider, my sights are set on doing what can we to better support people, their families and communities now and in the near future. This requires bold investment of time, money and political capital to correct the course of our scientific research and clinical treatment of mental distress, so the supports we offer go beyond symptom management to real wellness.

What convinced me to accept the leadership of the board this past March is the exciting opportunity it affords to link social entrepreneurs to the innovations that will increase the people’s ability to thrive.

There is untapped passion alight in the hearts of millions across the globe who daily walk beside family and friends experiencing emotional distress, those who know firsthand the pressing need for better options to help people through their mental health challenges. As community leaders, we recognize that we cannot afford the high human and financial cost of our current methods. The time has come and the need is urgent.

Every day, we are coalescing a broader and deeper community of researchers and clinicians who are asking the right questions to effect the change we need. And every day we make new friends who wish to donate funds wisely to reach the answers to those questions.

Our community foundation approach links these two groups together. We connect donors large and small to leaders, researchers and innovators whose partnerships are transforming our shared vision for the future into a reality. With a variety of giving options to choose from, our donors can have hands-on involvement in their area of interest or simply speed along the great efforts already underway.

We are an international community and what excites me is that together we can quickly spread the word about the best ideas wherever they occur around the world.

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October 6, 2014 by Krista MacKinnon

Families Healing Together offers innovative online family mental health recovery education

Families Healing Together (FHT), an interactive online mental health education program, is improving access to recovery education and support for families supporting someone experiencing emotional distress. FHT was co-developed by the Foundation for Excellence in Mental Health Care along with Practice Recovery, a psychiatric survivor led training and consulting initiative, and Family Outreach and Response, a Toronto based family mental health support program. All three partners recognized the healing power of community and the value and importance of family mental health support.

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October 6, 2014 by Gina Nikkel, PhD

First Do No Harm

I had intended this article to be an overview of EXCELLENCE as the first Community Mental Health Development Bank and how together we can pool our resources to pay for much needed unbiased research as well as recovery-focused programs.

I also wanted to make the appeal for becoming one of our $1 million dollar donors so we can continue building our endowment fund or tell how, for a much more modest contribution, you can help us achieve our $250K Challenge Grant.

Instead, I am going to focus on what I see as one of the most critical issues we are all facing which is underscored by the people I come in contact with on a daily basis.  FIRST DO NO HARM.  It doesn’t take a medical degree to understand the basic rule of care: help people, and if you can’t, at least don’t harm them.  Of course.  And yet, we the healers, people with lived experience, family members, public policy experts, and community members are so busy shooting at each other over what mental illness is or is not and how we ought to treat “it”, we have lost sight of our basic humanity and the suffering and compassion that are indivisible parts of the human experience.  There are a lot of people in the world of mental health care who are showing compassion but not nearly enough.

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October 6, 2014 by Bob Nikkel, MSW

New Fund Launching Recovery-Oriented Continuing Education Course

The Mad in America Continuing Education Project is developing a series of courses that will be reasonably priced and accessible from home or office any time day or night.  The initial offering, starting in October of this year, will be a series of 3 one-hour modules on neuroleptics by Dr. Sandra Steingard, the medical director of the Howard Center in Burlington, Vermont.   Continuing Medical Education and Continuing Education Units for this first course have been approved for MDs, nurses and social workers, Licensed Marriage and Family Therapists and alcohol/drug counselors.

The project is organized as an “incubator fund” within the Foundation for Excellence in Mental Health Care and will one day become its own independent non-profit organization.

Additional courses will be offered by internationally-known researchers describing their long-term outcomes studies of people who have been diagnosed with “schizophrenia.”  In 2015, more courses will be offered that focus on the other classes of psychiatric drugs—antidepressants, mood stabilizers and ADHD medications prescribed to children and adolescents.  Courses will also be created on alternatives to over-reliance on psychiatric medications.   In its maturity, the project will offer ongoing 5-10 courses so professionals can pick and choose the ones most relevant to their work.

Further announcements about how to access, register and take the course will be forthcoming very soon at and


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October 3, 2014 by Kathy Brous

Polyvagal Theory: Trauma as Reptilian Freeze

Polyvagal Theory Book AmazonNeuroscientist Dr. Stephen Porges appeared in my last few blogs; let’s explore his 1994 discovery of the Polyvagal Theory.  Dr. Porges runs brain-body research at top psychiatry departments (University of Chicago and University of North Carolina Chapel Hill).

And he always says he wasn’t looking for a polyvagal theory. He was just researching ways to measure the vagus nerve, the 10th cranial nerve running between the brain stem and most of the body.

Until 1994, textbooks said there are two parts to the autonomous nervous system (ANS).  First, the sympathetic system mobilizes us for fight and flight, but is harmful if it stays on too long, making us tense, anxious and prone to disease. Second, the parasympathetic inhibits mobilization, so it was believed to be calming and healthy. Textbooks taught that “the net result was a balance between a pair of two antagonistic systems,” Porges says. The vagus nerve makes up a chunk of the parasympathetic; “it functions like a brake on the heart’s pacemaker.”1

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September 29, 2014 by Sandra Steingard, MD

The Problems of Non-Consensual Reality

Sandra_Steingard_MDIn a couple of weeks, I may see some of you at the MIA Film Festival. I am honored to be on a panel called “Re-Thinking Psychiatry” with two esteemed colleagues. In advance of the festival, I decided to write about what has been most central in my own “re-thinking”: my basic understanding of psychosis – when a person does not share consensual reality. It has been a fundamental re-think: how do we define it? how do we understand it? when do we intervene? how do we intervene?

When you are a doctor who believes that psychosis is the external manifestation of an altered brain state that best responds to a drug, you do everything you can to persuade a person who is psychotic to take the drug. People who experience psychosis are – at least in my experience of meeting and talking to them – often distressed. I have learned that the next thing I write will seem obvious to some and provoke anger in others: It can feel negligent, even cruel, to deprive people of a drug – even one fraught with many negative effects – if this drug will reduce the suffering.

Over the past few years, I have been in an odd situation. I still understand this perspective. However, I also have a deepening appreciation of alternative views. After taking a drug, a person does not always feel “better.” This is not exactly a new insight for me. Many years ago, I knew a woman who lived with a voice. She loved him – she was convinced this was the voice of a “him” – and she never caused trouble for others. She was content with her life. One day, however, he turned on her and in that moment she sought help. She was not so much looking for someone to take the voice away but for something or someone to sooth her broken heart. The initial help she was given came in the form of a pill. The voice went away, but with it went her zest for life.

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