Recovery from “Schizophrenia” and other “Psychotic Disorders” — New understandings of the mind and of madness can open doors to full recovery UA-10331854-1
≡ Menu

If you are new to this site, Questions and Answers about Recovery can be a good place to start!

How Psychiatry Almost Stopped Burning Man: A Story of Hell and Liberation

As Burning Man nears its 30th anniversary, USA Today has published an article attempting to explain how this still somewhat freakish event came into existence.  I enjoyed the article, but as someone involved in the origin story it tells, I believe that an important piece is being left out.  This relates to how misguided “mental health treatment” came close to disabling a key organizer of the early Burning Man.  This piece is a fascinating tale in itself, but more fascinating when considered as just one example of how a flawed approach to mental health treatment forms a barrier to many forms of cultural evolution and renewal, with oppressive consequences for society as a whole.

It seems to me that we commonly hear sanitized tales of creative accomplishment that leave out the churning chaos that these developments may have emerged from.  Then, when people do encounter such chaos or madness, in themselves or others, they see it just as something to be suppressed, rather than something more complex and full of potential as well as hazard.  Eventually, the fear of going near such chaos forms a kind of cultural straightjacket, suppressing everyone.

The USA Today article describes, as one of the events leading up to Burning Man, an event I organized where participants were invited to wander about downtown San Francisco acting as “mad” as they liked, knowing they were being watched over by “mental health workers” who were part of the “mental health tour” and who would keep them out of trouble with the public and make everything seem “under control.”  While the article reports that the purpose for this event was simply to see how “the public would respond to people who actually were in need,” my actual intention was to create a situation where people did not have to act “sane,” where they could feel free to explore other, more chaotic aspects of their being, and where such exploration would be made safe by the presence of tolerant others who would act as an interface with the often intolerant world we were immersed in.

This was important to me, because I had gone on my own journey through states that could be labeled “mad,” and I was also close to others who had similar experiences, some of whom were getting pulled into a mental health system that focused on suppression of such experiences rather than making it safe to explore them.  And one of those people I was close to at the time was John Law, who later became one of the three primary founders of Burning Man, and who also provided critical financing that allowed Burning Man to survive in the years before it pulled in sufficient funds to finance itself.

It is Law’s story I want to focus on here, in particular the story of how psychiatry almost managed to pull him into the role of a chronic mental patient.  I believe this story is important because it naturally leads to the question: how many people like him might be making amazing contributions to our world, if they weren’t getting “helped” by being pulled into a system that is focused on suppressing their experience rather than understanding it and seeking to find what is of value within it?    Anyway, here’s the story:

At age 16, Law was starting college in Tennessee, financed by a “rehabilitation scholarship” meant to turn him around after a period of juvenile delinquency. He was living in a dorm, away from his family for the first time.  He had no clear idea of what he wanted from attending college, though he had chosen forestry as a major.  On the social front, he was involved with friends who liked to drink a lot and pop pills like various forms of “speed,” and to get money for all that as well as other needs, he worked as an engraver in a jewelry store.

It wasn’t going very well however.  His focus on his education was not strong, as he didn’t have a clear sense of what he wanted to do with his education or with his life.  And with all the substance use, and the stress of trying to work a job as well, it seemed impossible to study effectively.  His mental state became increasingly foggy.

Then something big happened:  a student in the dorm attempted suicide by jumping out of the building.  Law isn’t sure if this succeeded or failed, but in the process the window to Law’s dorm room was smashed.  This had a big impact on him, and in his foggy state of mind, he began to wonder if it was actually he who had jumped.  Then, he began thinking he had actually succeeded in killing himself and was now in hell.

Still carrying those feelings some days later, he went to work as normal.  But things weren’t normal.  As he watched a co-worker, he saw the man’s fingers appear to multiply till there were 8 or 10 on one hand, and a monocle over his eye used for the engraving work also appeared to multiply; then he looked directly at Law with a clearly demonic leer.

Law’s response was to bolt from his workplace, and to call a cab, requesting to be taken to a mental hospital (or something).  He didn’t know what was wrong exactly, but suspected it was something to do with his mind.  The cab driver took him to an outpatient facility connected to the university.  By that time Law’s thinking had shifted and he was convinced the driver was part of a giant conspiracy against him, but he paid his fare anyway and walked into the building.

There, not knowing how to describe what was happening to him, he explained he had just taken a massive dose of LSD and was having a bad trip.  (He had actually not taken hallucinogens in recent months.)  Rather than talk to him about his experiences however, or provide any kind of comfort, agency staff simply placed him in a room and told him to wait.  After what seemed like a long while, Law got up to leave:  but two staff members followed him, forced him to return and then locked him in the room.

Once locked inside the room, there was nothing to do but to watch the clock.  It was a big clock, that made a big “click” as each minute passed.  Then it stopped dead; Law found that odd.  Finally, a doctor entered the room, who looked to Law like a corpse, which made him recoil.  The doctor said nothing much, but reached out to take his pulse.  As this was happening, Law looked at the time on the doctor’s watch – the exact same time as the time the clock on the wall had stopped!  This was too freaky, so Law pulled his hand away.

What followed was foggy – getting sedated, and then shipped to a hospital.  Once there, it seemed he was an object for study, and he was convinced the other “patients” were graduate students playing a role so they could better observe him.  No one really tried to talk to him though, and he refused to say anything to anyone, at least until one evening a young intern approached him.  The intern was very friendly, and talked to him for a long time, until finally Law opened up about his life and family and his experience of being in hell.

But that’s when things went very wrong.  Instead of continuing to listen and explore, the intern began explaining to Law that perhaps if he invited Jesus into his life, he might get out of hell!  Feeling manipulated, Law yelled and attacked the intern, knocking him down.  What followed was restraint and another injection.

This was not the only time Law became violent on the ward – he estimates there were three or four times in total.  And while to outsiders his fits of agitation may have seemed simply “crazy,” there was a story he could have told about each one, had anyone cared to ask him.

For example, there was the time he was, with the other patients, watching Walter Cronkite deliver the news.  Like many Americans, this was a routine for him long before coming to the hospital, and he very much trusted Cronkite and his sidekick Eric Sevareid to speak objectively about the facts of the day.  This evening, the news seemed to be about a “pygmy uprising” in Africa.  As Law watched, feeling complete trust in the objectivity of what he was seeing, Sevareid stopped in the middle of his commentary, looked directly at Law, then pointed at him – and his finger came out of the TV set – and he declared “You are in hell!”  Law can’t now recall exactly what his response was after that, but it was very agitated and the hospital responded with more restraint and sedation.

Law recalls that the whole hospital experience lasted at least two weeks, probably less than a month.  Eventually he stopped hallucinating, perhaps as a result of the drugs, but he was not talking to anyone, and he felt he lacked the mental capacity to form words into sentences.  (From a psychiatric perspective, this was cognitive dysfunction and negative symptoms.)  Law isn’t clear on why the hospital agreed to release him in this condition, but he suspects that his father pushed for it.  His father was a college professor with a long history of standing up to authorities and bureaucrats, and was already skeptical of mental health treatment approaches as they had impacted another family member.  (Parents and other relatives cannot always make a difference like this, but in Law’s case, his parent’s willingness and even likely insistence on taking him home was probably pivotal in his recovery.)

Once home, things did not always go smoothly.  But Law doesn’t remember anyone insisting he continue to take drugs, and he recalls his mom taking him on long drives, during which he was again vividly hallucinating, probably as the drugs wore off.  Law himself was not inclined to talk, and his parents were stressed and his father avoided any talk about what had happened, while his mother talked about it only a little.  But his younger sister wanted to talk about everything, and Law started responding to her, and as he did he started coming back to himself.

But this return to himself came with more problems.  He didn’t know what to do with the shame of having failed to make good on his scholarship.  And his family was not happy when he started reconnecting with the friends with whom he drank and took pills.  This came to a head one night and an argument with his dad became physical, and his dad, a former boxer, punched him and knocked him out.  Overwhelmed by this event, Law packed up that evening and left home.

That night, camped out by the side of the road, he sobbed and felt his life was ruined.  The next morning however the sun came out, and he felt the promise of new beginnings; he decided he was a completely new person!  He hitchhiked to Michigan to meet up with my brother Ken, a close pal of his since second grade.  A few months later he and Ken hitchhiked to the SF Bay Area to visit me, and then Law decided to relocate there.

The timing of this was great for me, because I had just alienated the one friend who had been close to me during the last couple years when I had been going through my own altered or “extreme states.”

Unfortunately, the first time we became roommates together didn’t work out too well.  Law was inspired to recreate something like the Haight Ashbury “crash pads” made famous during the late 60’s, but many of the people he invited in to stay rent-free were a bit difficult to get along with.  For example, I recall the guy who decided he would paint a mural on the dining room wall, and who expressed certainty that it would be such a great work of art that the rest of us should be happy to let him eat our food and then clean his dishes for him.  When I (among others) critiqued this plan, this guy and his friend threatened to murder me.  Soon, there was no one left interested in paying rent, and the whole situation collapsed.

From a mental health system perspective, this housing disaster would be taken as evidence of both grandiosity and poor judgement on the part of Law, evidence that he was still “mentally ill.”  From a more open minded developmental perspective though, that same story could be taken as evidence of his emerging creativity and leadership qualities, even if mistakes were being made along the way.

Our second attempt at being roommates, a few months later, was more successful.  At the time we were both employed and fitting in enough to get by, but also deeply alienated from conventional society and looking hard for ways to create something really different.  For a while, we just talked together and imagined the sorts of things we might like to see happen.  Then, I was lucky enough to learn about a rather obscure but innovative institution called “Communiversity,” and Law and I together joined in for the initial meeting of its most famous “class,” the San Francisco Suicide Club.  I liked it a lot, but for Law, it was magic:  he quickly found his role as a leader first within the Suicide Club, then in the follow-up group the Cacophony Society and eventually, Burning Man.

Interestingly, while Law’s story is told in many places, such as the historical book This is Burning Man and in Law’s own book Tales of the San Francisco Cacophony Society, the part about an encounter with madness and with psychiatry is not included.  Mention is made of his record as a juvenile delinquent, but no words about his time as a mental patient.  When I asked him about this, he explained that in order to really build a new identity for himself, it always seemed necessary to put everything about madness and psychiatry away, to bury it.  Fortunately, he is now willing to be open about this part of his past, and he has approved this story as it is written.

From my point of view, the really sad thing is that so many people who go through experiences like Law’s do not ever manage to break away from psychiatry and build a new identity.  They are taught to see their internal chaos as simply “illness” and to focus on fighting it, rather than learning that if approached correctly it can also be a source of creativity and personal and possibly cultural renewal.  That’s why I think it is essential that stories like Law’s be told and understood, so we really come to understand madness itself in a completely different way, and to respond to it much differently.

Interestingly, while madness often follows childhood trauma, that was not part of Law’s story.  Both his parents were loving, and he related well to siblings and peers.  He had a particularly strong role model in his father, who showed courage in standing up against racism and corrupt bureaucracy within the academic world in which he worked.  But there were also big contradictions in his life and upbringing that weren’t being addressed.  His parents had sent him to Catholic school, where the rigidity he encountered didn’t gel with the independent thinking he had learned from his dad.  As he entered high school, he was introduced to various forms of rebellion in the form of drugs etc., but nothing that formed any coherent path to a future existence.  By the time he entered college, he had one foot into trying to “make it” by conforming to a society that seemed rigid and meaningless, and one foot into drugs and thoughtless rebellion that also offered no future.  Nothing was working.

Further, while Law’s dad was articulate and courageous when confronting obvious corruption, he was not adept at talking about deeper contradictions of the conventional society that he was part of and which he encouraged his son to join.  So there really wasn’t a forum within his family or with anyone else he knew at the time for talking about the contradictory pressures he was experiencing.  Unfortunately, a bind becomes a double bind when one can’t talk about it.  There is no longer any conscious way out of the mess:  instead, the existing order has to break down if there is going to be any relief.

For Law, this meant entering “hell.”  From the point of view of psychiatry, the problem was that he thought he was in hell when he wasn’t, but from a more humanistic point of view, the problem was that his life was indeed turning into hell.  To get out, he first needed to experience that consciously, then he needed to let the fixed beliefs about his life that he had previously identified with “burn away” so that he could resolve the contradictions and find a new path.

From the point of view of many traditional cultures, this is all very understandable.  Shamans routinely understood they would have to go through things like experiences of dismemberment and destruction in order to explore new forms of existence and experience.  But psychiatry focuses only on the suffering involved in “breakdown” and ignores the possibility of “breakthrough” and renewal that can follow, if only people get the support they need to allow their psyche to reorganize into something new.

When I think of Law’s story, I find the image of the “pygmy rebellion” to be especially interesting.  One reason madness can be so terrifying is that parts of our mind with which we were previously barely familiar can be suddenly doing things that throw our whole system out of control.  This “rebellion” of the less conscious parts of our mind can be understood to happen as an attempt to free us from the ways we are stuck, but if we then feel too threatened by its actions and just focus on attempts to “put down the rebellion and restore order” then the end result can be getting stuck in struggle, or what Eleanor Longden called a “psychic civil war.”

When Law decided to see mental health “help” he was experiencing profound alienation between his somewhat paralyzed and stuck conscious mind and less conscious parts of his mind, the latter of which were playing terrifying games with his sense of reality, for example “taking over” the image of favorite news announcers to instead make proclamations that were “delusional” if understood literally, but which did accurately describe what was going on in internal reality.

One of my favorite philosophers, Alan Watts, was fond of pointing out that if one’s car goes out of control on a slippery surface, the way to regain control is somewhat counterintuitive:  one must turn the steering wheel in the direction of the skid.   This is the equivalent of finding something of value within the madness and then going with it, developing it.  The mental health system of course does the contrary, it focuses on turning against the skid, attempting to completely suppress the “madness.”

But fortunately for Law, he was able to slip outside the grasp of psychiatry, and then to “turn in the direction of the skid” and to join in rebellion against the established order in a more conscious way.

Law never again had a “psychotic episode.”  Instead, he joined with others who had experienced similar bouts of alienation, to experiment with altering their own and other people’s sense of reality, so helping many discover that sense of freedom and play that had earlier emerged as that rebellion inside his own mind.

Interestingly, Law’s allegiance to play and resistance to fixed structures of authority led him to argue that Burning Man should be disbanded once it became large enough to require rules and more established authority.  In the last year he participated, 1996, the theme involved an attempt by corporations, allied with Satan, to take over Burning Man itself.  The video below captures some of the spirit of that event, and includes an image of Law “fighting back” against the corporate powers by climbing to the top of their headquarters, Helco Tower, setting off a bomb to ignite it, and then escaping via zip line:

Life itself is beset with contradictions.  “Revolutions” of various sorts can make room for new life, but they quickly collapse if we don’t do anything to support them, to stabilize the new forms that emerge.  Unfortunately though, the very efforts we take to stabilize our lives often turn and threaten to become deadening.  An interesting reflection on this process was expressed by the Kafka quote that recently appeared on MIA, “Every revolution evaporates and leaves behind only the slime of a new bureaucracy.”

Opinions now vary as to whether Burning Man continues to be a dynamically growing and vital revolutionary event, or if it has itself become a soulless monster in need of being destroyed so something new can emerge.  But leaving that dispute aside, I want to focus on two more basic realities:

First, it seems that no matter how “life supporting” our personal mental structures and identities or our cultural forms and frameworks may be, they do eventually run into problems, they become “soulless” and in need of renewal.  Having them break down or burn away can be painful and even dangerous, but this process can also be vital, and may be required so that new life can emerge.

Second, we really need a “health” system that understands and supports this process of breakdown and renewal, rather than attempting to simply suppress it. John F. Kennedy has been quoted as saying that “Those who make peaceful revolution impossible will make violent revolution inevitable.”  When we attempt to suppress revolution in the mind, those revolutions just become more chaotic and difficult to understand, and “chronic psychosis” becomes much more likely.

Fortunately, other pathways are possible.  Lots will have to change, but telling and reflecting on the stories of those who found such alternative routes is one step toward creating a future where the norm will be for people to be supported in working through their personal revolutions in whatever way makes the most sense for them.

And then maybe, with luck, the very people we learn to help effectively will then turn and help the rest of us find pathways toward a very necessary cultural renewal.  That is, their ability to see things differently may eventually help us all find radical alternatives to the current pattern that David Oaks calls “normal people destroying the planet” or “normalgeddon.”  That’s the bigger challenge…….

The book “Rethinking Madness” is now free!


The book “RethiFRONT_Cover_Final (2)nking Madness: Towards a Paradigm Shift in Our Understanding and Treatment of Psychosis” by Paris Williams is now free, in pdf version, at this website.  That’s cool, because the book is a good resource in understanding how psychosis can be understood in a psychological way, and how recovery can be supported.  Paris Williams has thought deeply about these issues, and has a good understanding of both the problems and the possible solutions.

Voices in the Head: A Documentary

I’d like to recommend a documentary show, 52 minutes long, which includes a lot about trauma and psychosis, and includes some interesting bits that relate to the interesting intersection of Compassion Focused Therapy with Voice Dialogue methods.  Eleanor Longden and Charlie Heriot-Maitland both appear in the film, and are leaders in these innovative approaches.

The documentary is in German, but with English subtitles.  (If you click on the “version” tab at the top of the screen, you can also access a version dubbed into French or with Spanish subtitles.)

Here’s the link:

Are They “Symptoms” or “Strategies?”

What exactly are “mental health problems”?

In the mainstream, psychological difficulties are seen as “symptoms” of an “illness” or “mental disorder” and based on this the focus is put on suppressing them, either by using drugs, or shock, or by psychological interventions that also aim to “eliminate the problem.”

Unfortunately, this mainstream approach often works poorly, and too often its main effect is to aggravate the problem, or to cause “collateral damage” as critically important parts of the person are suppressed along with the supposed “symptoms.”

But if we want to replace the mainstream approach, we need a coherent alternative view, which realistically frames both the difficulties people experience and suggests better approaches to resolving those problems.

One avenue to this needed reconceptualization was expressed by Jacqui Dillon, who wrote that  “When you understand your own ‘symptoms’ as meaningful and essential survival strategies, a more respectful and loving acceptance of yourself begins to emerge.”

I like a lot about that perspective and the shift in attitude it suggests.  It helps explain why the traditional approach does so poorly – it’s difficult to heal if we are thinking of essential parts of ourselves as an illness!

There is one possible complication with this perspective though: if we think of disturbing patterns of experience or behavior as being “essential” then we might also feel stuck with them just as they are, with no alternative but just learning to accept and respect them no matter how much trouble they are causing.

One way out of that bind is to think of “symptoms” as meaningful strategies that do fit and are indeed essential in some kinds of situations, but which also are often put into action unconsciously or without much thinking or in mistaken ways.  That is, at times they may be truly necessary for our survival, at other times they only seem necessary to some part of our psyche that activates them, while in reality they may be “going too far” and backfiring with destructive effects.

Defining them this way allows for more ambiguity, and suggests that each strategy etc. must be looked at in context, to sort out what really is essential or at least helpful in a given situation from what is well intended but misguided, and may be currently destructive.  From that perspective, what we need is not wholesale suppression of what disturbs us, or complete acceptance, but rather an increase in discernment about what strategies are working or not, in particular situations.  A strategy that truly was lifesaving during a traumatic situation, for example, may be extremely damaging when carried on into everyday life:  but if we can appreciate the way it saved us at one time, we may also be better able to “let it go” in a present that no longer requires it.

To clarify this reconceptualization, what I would like to do now is to outline some of the major categories of psychiatric “symptoms” and describe how they can be reframed as possibly helpful, though often harmful, strategies:

[click to continue…]

Psychiatry: Worth Keeping If “Slowed Down”?

The faults of modern psychiatry are numerous and profound, and many readers here know firsthand about its destructive force.  But are these faults so vast that there is nothing worth saving?

Bonnie Burstow has suggested that facts lead to “the inescapable conclusion that psychiatry has no foundation and should be phased out”  Elsewhere she has written about “psychiatry’s utter invalidity” and suggested that reform cannot work, as it will be inevitably coopted.

Philip Hickey has also supported an “anti” psychiatry perspective, suggesting that psychiatry is now “so rotten and flawed that anti is the only appropriate stance consistent with human decency.”

I am sympathetic to these arguments, but I am also concerned they may be too extreme to be practical in a world that could still benefit from a medical specialty focused on mental and emotional problems.

Of course, I don’t mean at all to say that mental and emotional problems are typically “medical” in nature, as I believe they more commonly are simply reactions to difficult events or environments, which can in turn be worked through with some human understanding and non-medical assistance.

But I would propose there are three legitimate roles for a medical profession specializing in issues related to the mind and behavior:

[click to continue…]

Getting Back to Dialogue – The Core of Healing!

When people are “mad,” they are often insisting that certain things are so, and frequently seem unwilling or incapable of appreciating or learning from other perspectives.  Yet when the supposedly “sane” mental health system approaches those who are mad, it typically does the same thing – it insists that its own view of what’s going on is correct, and seems incapable of appreciating or learning from others, whether they be the patient, the family, former users of services, or anyone who understands madness in a different way.

So what’s going on with that?

One way of understanding it is to reflect on the very human tendency to narrow one’s perspective when feeling threatened.  When people feel threatened, they tend to narrow their focus down to what they believe may avert the threat, and to shut out other perspectives that seem “wrong,” or that could lead to doom.

That works fine when the threat is relatively straightforward, and a solution can be arrived at which reduces the sense of threat.

But what about when it can’t?

When individuals are facing situations where there seems to be a dire need to solve a problem, yet no solution nor path toward such a solution is apparent, the person naturally enters into a state of conflict.  On the one hand there is above mentioned drive to narrow attention in response to the threat, but on the other hand, there is a drive to expand awareness and experiment with unusual ways of looking at things, so as to possibly find a pathway to a solution that otherwise appears impossible.

It may be that it is the collision between the two tendencies, the narrowing of attention to focus on threat, contrasting and conflicting with the expansion of awareness while seeking to control what otherwise appears uncontrollable, that is responsible for the wild states we call psychosis, or madness.

So we see people who seem creative in some ways, often coming up with very imaginative interpretations of reality, yet who also seem very unimaginative and closed minded when it comes to seeing any down side in their point of view or being able to follow how and why others see things differently, or seeing how to negotiate in a world where others do see things so differently.

Those who are “mad” can then seem difficult to communicate with – their attention seems narrowed and entrenched in their point of view.  We might say they are stuck in “monological thinking” and have difficulty with dialogue, with really appreciating and reflecting on the views of others and learning from them.

Unfortunately, these difficulties can be so intense that those around the “mad” person typically enter into their own kind of threat response, and narrow their own attention, and become stuck in their own “monological thinking” in an attempt to cope.

In the monologue of the traditional mental health system, a “solution” for the problem of madness is outlined.  The mad person is simply experiencing an illness, one that has a name and a clear treatment plan, organized around attempts to suppress that “illness.”

The great thing about having this sense of a “clear path forward” is that it helps professionals and those around the mad person not feel mad themselves.  That is, rather than feel there is a problem that urgently needs solved yet for which there is no identified path forward (the bind that could lead to madness), it is now possible to feel there definitely is a path forward – just narrow down one’s thinking and doing to the medical style approach, and no doubt or further reflection or inner conflict is required!

But now we really have two clashing and very imperfect monologues – that of the “mad “person, and that of the mental health system and those persuaded by it.  And what happens when two fixed views confront each other?  Research shows the tendency is for people who feel confronted to dig in and get more entrenched in their views – and the possibility of dialogue, of reaching across the divide, and of healing, becomes more remote.

But fortunately, there are better approaches!  They are less simple, and involve deliberately accepting uncertainty, and taking some risks, while also attending to safety concerns.  These methods emphasize dialogue, and fight back against that tendency for narrow thinking in response to threat.  Instead they embody a wisdom that recognizes we all best face complex issues when we are willing to be wide and open enough to hear all the voices, and that “sanity” is most likely to emerge through this sort of dialogical process, when it takes place not just within the “mad” person but also within the social network and treatment team.

The Hearing Voices Network makes really important strides in this direction – emphasizing for example changing relationships with voices rather than defining them as illness or suppressing them.  There are now some forms of psychological therapy for “psychosis,” such as the style of CBT for psychosis that I teach (online as well as live) which emphasize relating in a dialogical way.  But it is Open Dialogue, and the dialogical practices it has inspired, which have uniquely framed mental health work as being fundamentally about encouraging dialogue, and which often achieve amazing results just by aiming to support dialogue on all levels.

I was inspired to write about this now because I have been publicizing an “online meeting” or webinar with Mary Olson, titled “Introduction to Dialogic Practice.”  This meeting has already happened, but you can listen to a recorded version of it at this link.  (It may take a couple minutes to get started, so be patient!)

[click to continue…]

Why Trying To Suppress Voices Often Backfires, and What To Do Instead

When people are distressed by voices and the impact that hearing voices has on them, it isn’t surprising that their goal often becomes getting rid of the voice and suppressing whatever message might be associated by the voice.  The mental health system often takes the same perspective, seeing the voice as itself representing a mental disturbance or disorder, and defining health as no longer having the experience.

But what if attempts to suppress experience in this way are actually likely to increase disturbance or disorder?

I created an 11 minute video which explores how and why problems emerge when people try to suppress experiences such as hearing voices, and which identifies strategies that are much more likely to be helpful.  The video is called “Reasons to be wary of attempts to suppress “hallucinatory” experiences” and up until 3/16/16, it’s available as a free preview within the online course CBT for Psychosis.

Just go to this link, and you will find the link to preview this video, as well as some other free previews.

The online course itself is also available for a 67% discount, only $29, up until 3/16/16.

“Schizophrenia Breakthrough” – Or a Case of Ignoring the Most Important Evidence?

Last week, the headlines were blaring: Schizophrenia breakthrough as genetic study reveals link to brain changes!  We heard that our best hope for treating “schizophrenia” is to understand it at a genetic level, and that this new breakthrough was now getting us really started on that mission, as it showed how a genetic variation could lead to the more intense pruning of brain connections which is often seen in those diagnosed with schizophrenia.  We were told that this study was very important.  “For the first time, the origin of schizophrenia is no longer a complete black box” was one quote.  And the acting director of the National Institute of Mental Health (NIMH) described the study as  “a crucial turning point in the fight against mental illness”.

But is all this hype justified?

A “back story” to this article is that the NIMH has a long history of bias toward biological approaches to understanding mental and emotional difficulties, with an accompanying tendency to ignore even the most obvious evidence that these difficulties often relate to problems in living experienced by people.  For example, even though numerous studies confirm that adverse childhood experiences make a later diagnosis of schizophrenia much more likely (more so than do any particular genes), the NIMH, on a website about the possible causes of schizophrenia, claims it’s “unknown” what kind of psychosocial factors might contribute to putting people at risk.

But it really isn’t a mystery.  To people like NYU professor Brian Koehler who have been following both the biological and the psycho-social research for decades, it’s clear that the real story is that the biological differences we often see in people diagnosed with disorders like “schizophrenia” are often the result of stressful life events, not something that requires specific genes (even though it may be true that some genetic variations increase vulnerability to some limited degree.)

Below (with his permission) I am quoting a recent email from Brian Koehler, where he shared some of what we would be hearing from the media if the medio were being given the whole story.  (His writing will make more sense to you if you understand that microglia are the type of brain cells active in the synaptic pruning that was being discussed, though only in reference to possible genetic causes, in the articles about the recent “breakthrough”…..) [click to continue…]

Madness and the Family: What Helps, and What Makes Things Worse?

Families are often very important for people encountering severe mental and emotional difficulties.  but how can family members really know what is helpful, and what is likely to make things worse for the person having problems?  Similarly, for those who want to help families, how can they know what will really be helpful for those families, and what will make things worse?

H. L. Menken wrote that “There is always an easy solution to every human problem–neat, plausible, and wrong.”  In the case of madness and families, there are a number of such easy solutions, all, unfortunately, also quite wrong.

But that doesn’t mean there can’t be real solutions.  It just means that we might have to reject the simple, formulaic solutions in order to search together for the humanistic, complex, and individually tailored solutions that might really fit particular people and families.

Paris Williams recently wrote a 3 part series on Madness and the Family, see Part 1, Part 2, and Part 3.  If you found those interesting, you might also appreciate hearing a 45 minute talk he gave on the same subject, which you can view by going to

One of the trickiest issues in just thinking about families and madness is the whole question of whether or how much to “blame” families for the madness that seems to be located in a particular family member.  Biopsychiatry and NAMI of course would say families have no responsibility, other than most likely to have passed on what are presumed to be bad genes, while at the opposite extreme, there have been those who thought the existence of madness was proof the family had essentially created the madness.

But when we step outside the world of biopsychiatric or other sorts of dogmas, it appears that issues are much more complex, even perhaps “diabolically” tricky.

As individuals, we try to make our lives better.  But sometimes our efforts to make our lives better makes other parts of our life get worse, or even way worse.  And if we don’t recognize what is happening, our whole life can spiral out of control, can spiral into “madness.”  Similarly, even well intended families can do things they hope or believe will make things better, but these things may really cause problems for family members or make existing problems worse, in ways that may not be recognized.  And then of course the mental health system and other outsiders can also come in and try to make things better, but really make things worse, in ways that may not be recognized.

So, at all levels, even well-intentioned efforts can become part of a “storm” of madness, and while this storm often appears centered as a “disorder” in one person, really the confusion of many can be playing a part in the chaos.

Of course, when not everyone has great intentions, and when abuse is or has been present, things can get even more complex.  So abuse etc. is important to discuss when it has been present, but it’s also important to not presume anyone has been abusive.  Each story of madness is unique, and better approaches are interested in that uniqueness.

One way of understanding it is that people go mad when they encounter key life issues, binds or double binds, that they can’t resolve within the understanding of themselves and their world that they have put together up until that point.  Madness in a family member in turn creates huge and confusing dilemmas or binds for the rest of the family, and this makes it difficult to respond in ways that don’t inadvertently feed the madness.  But when all of this can be talked about, pathways to healing and recovery for all sometimes open up, even if not easily.

Why Does Mainstream Psychiatry Fear a Balanced Understanding of Psychosis?

Many people are now familiar with the BPS report, Understanding Psychosis and Schizophrenia, and they have appreciated how it integrates both science and a humanistic understanding to convey a fresh and progressive approach to difficult and extreme experiences. But it has come under attack by psychiatrists such as Ronald Pies, who wrote an article accusing it of “trivializing the suffering of psychosis” and of failing “our sickest patients.” Others offer similar arguments, such as Joe Pierre M.D. who suggests the BPS report “romanticizes” psychosis.

The arguments offered by Pies and his allies are often quite slick, and sound reasonable to the uninformed. But they are wrong, and the better we can articulate how and why they are wrong, the better we can advocate for a more humane and skillful response to people having the experiences that are called “psychosis.”

In his article, Pies states that

What is lamentably missing from the BPS report is any deep understanding of the psychic suffering occasioned by severe and enduring psychotic states, including but not limited to schizophrenia. Indeed, I believe the BPS’s attempt to “normalize” psychosis winds up trivializing the immense psychic pain and agony experienced by many persons diagnosed with schizophrenia and related disorders of reality perception.

He goes on to provide a vivid example of a man describing severe distress related to attacks he perceives as coming from others, and he suggests that psychiatrists like himself see this sort of thing all the time, while the BPS authors, he concludes, seem to be unfamiliar with deep difficulties.

But it’s not true that the BPS report fails to include mention of terrible experiences – it includes for example mention of a sense of one’s blood being poisoned, of going to hell, of “the worst feeling I’ve ever felt.” It should also be noted that the BPS report was written for a public trained to associated psychosis with horrors of various kinds. So there was really no need to spend a lot of time letting people know that psychosis could go badly. Instead, the report was aiming to increase awareness of how psychosis could possibly be met with understanding and reasonable hope.

So, we might ask, why is it so important to Pies and to others within mainstream psychiatry that the emphasis is put on what’s awful about psychosis? And why are attempts to understand psychosis as possibly not all that different from everyday human difficulties seen as so threatening?

When people intensely fear something, they look for relief from that fear in a less critical way, and they are happy to give power to whatever offers protection against the fear. Our society gives great power to psychiatry in a very uncritical way because it fears psychosis, it fears madness, and psychiatry and psychiatric drugs seem to offer quick protection. So while some psychiatrists may over-emphasize fear of psychosis simply for the same reason that we all sometimes get overly caught up in fearful reactions, it’s important to notice that psychiatry as a profession is also motivated to emphasize fear of madness because that is what causes the public to give psychiatry its power and prestige, while also inducing that same public to ignore any criticism of psychiatric practices (much like the way a public scared of terrorism will not question the military, spy agencies, or often, even the practice of torture).

Fear of others is promoted when we focus on their differences, their “otherness.”  The ways people are different should not be ignored, of course, but a better idea is to make sure we notice both commonalities and differences, in a balanced way.  Balance in general is associated with complexity and nuance, and not with certainty about a correct course of action: but psychiatric power depends on a clear belief that any “psychotic” state of mind is very very bad, and cannot be understood in an ordinary human way, and must be continuously treated by drugs to suppress it, etc. [click to continue…]