Fish stew and cravates

Chris made a pot of fish stew last night, which is noteworthy for many reasons. The stew was absolutely delicious. Chris went out and bought the ingredients, consulted a recipe book, and produced a glistening, mouth watering concoction of white fish, clams, and red and orange peppers in a reddish broth. His brother Alex heartily complimented him on the meal.

In the past, Chris’s culinary skills were lacking. He didn’t seem to care what he ate or how it looked. Remember the peas or carrots? He let me choose. Recently, he announced to me that he wants to take more care with how he does things and how he looks. It is possible that his sense of taste and color are reviving. I have been down this road many times since Chris’s problems began. Small things make me excited. We have all experienced these small victories.

He is still wearing the same dull necktie that he bought when starting university. “I began to think something was seriously wrong with Chris,” my husband said, “when he chose the dullest gray tie imaginable from a rack of real beauties.” My husband is a tie person.

Chris is intellectually able but does not wish to, or is not able to, pursue academic studies at this time. I wonder if he is more an artist now than the promising academic he seemed to be in high school. I do not take his lack of academic ambition as a sign that he has suffered intellectual impairment. Instead, I see a young man with a lot of musical talent and untapped creativity.

A culture of low expectations

The other day I attended a lecture by a prominent psychiatrist. The topic was stigma surrounding the mentally ill. He had done an extensive study focused on people with schizophrenia. He found that often people with schizophrenia practice stigma against themselves and cited an interview he had with a schizophrenic man who believed that he could not work. “Where did he ever get this idea?” the psychiatrist asked, genuinely puzzled that the man operated under this belief system. I was impressed by this psychiatrist because it was the first time that I had ever heard a psychiatrist use the words “work” and “schizophrenia” in the same sentence. By “work”, I am talking about a full-time paid job, not volunteer work. I hope he was thinking the same. However, that he was puzzled about why his research subject would hold this opinion was troubling.

It is no surprise to the rest of us where this man gets the idea he cannot work. It starts with the psychiatrist, who generally has a gloom and doom attitude surrounding what people with schizophrenia diagnosis are capable of doing. If you want to see a brief look of panic/unease register on your psychiatrist’s face, try suggesting that you would like to get your driver’s license. Then, we move on to well known organizations’ and institutions’ websites that describe schizophrenia as “the most serious of the mental health disorders”. They talk about schizophrenia in terms of functionality, social housing options and quality of life, as if that’s the highest standard one can aim for. They talk about schizophrenia as a disease of the brain. They rarely, if ever, mention full time jobs. They talk a lot about hope, but I think our man can read between the lines. He has gotten the message right.

Reading between the lines for help

I must say I am beginning to get weary of reading between the lines when it comes to finding helpful therapies for schizophrenia. What I mean by this is that there are many potentially useful therapies out there for autism, dyslexia, attention deficit disorder, pervasive developmental disorder, depression, etc. Rarely does the word “schizophrenia” appear in the list of conditions treated. So, once again, I gotta make the link myself. It’s not like these problems are really all that different, so why does schizophrenia perpetually fail to make the list?

Schizophrenia deserves better. I am pleased that there is now serious focus on autism , but let’s also keep in mind that schizophrenia is more prevalent in the population, and has serious social and economic consequences. In many ways, schizophrenia and autism are not that different, so why this disparity of focus? Is it because schizophrenia happens to adults or is it because schizophrenia is still thought of as untreatable, or both? If you really pay attention, the child who goes on to develop schizophrenia as an adult shares at least some of the traits in one or more of these other conditions.

Chris is currently doing the Tomatis Method. He goes to the center at 9 a.m. to avoid the crush of children at the end of the school day. Tomatis is a method of auditory training incorporating the music of Mozart and Gregorian chants. I had to read between the lines to see if it could be useful for schizophrenia. Apparently, it can be. I understand that the one and only article written by Dr. Alfred Tomatis on his method’s applicability to schizophrenia is in French and has not been translated for a wider audience. I will write more about the Tomatis Method later when I get a better feel for any observed benefits.

Hearing voices

I remember vividly how the the subject of voices was handled the one and only time it was raised during the bi-weekly meeting with other patients and families. It arose because one young man suggested during the meeting that people learn to make friends with their voices, as he tried to do. A worried look flashed between the staff members present. “You must ignore them!” they exhorted. Other group members nodded in agreement, but they seemed uncomfortable, judging from the somewhat embarrassed silence that followed. The topic was dropped. After that, people like me knew better than to bring it up.

Now, this to me is ignoring the elephant in the room. For a whole slew of patients, medication doesn’t quell the voices or the visuals. Medication wasn’t effective at stopping Chris’s “fleetingly improvised men” and I often thought that the medication actually aggravated them. It sure didn’t tame them. The higher the medication, the more sedated you are, but voices and visuals can still persist. The program’s approach was to try to medicate the voices.

An alternative, more sensible theory about voices, first promulgated by Dutch psychiatrists Marius Romme and Sondra Escher, was that voices are indicative of something else going on with a schizophrenic that medication might be able to help in the short term, but couldn’t fix in the long run. The Hearing Voices movement founded in Manchester, England, in 1989, and Intervoice, an international online community, are two of several self-help groups based on Dr. Romme’s work. Members meet to share experiences and learn to recognize that the voices may be expressions of their own subconscious. The emphasis is on personal growth for each individual.

Dr. Marius Romme believes hearing voices is not an illness. The voices are messengers that speak about certain problems that occurred in the person’s life. If you try to kill the messenger by ignoring the voices or medicating them, you often make them worse, you fail to address the deep-seated problem, and the result is a chronic patient. The difference between patients hearing voices and non-patients hearing voices is their relationship with the voices. People who never become patients accept their voices and use them as advisers. In clinical settings, however, voices are almost always seen as evil messengers and are considered a sign of schizophrenia. This is bad news for the patient.

The glass half empty

Humoring Dr. ‘L’ was becoming increasingly difficult. We left the meeting with the understanding that the medication would be increased no more than 100 mg. Chris came home the following week with a prescription for an additional 200 mg. I e-mailed Dr. ‘L’ questioning this increase. He replied:

“I am surprised at your question, which indicates that I haven’t been clear enough, so excuse me. Chris suffers very handicapping auditory hallucinations as we have confirmed from our last meeting. In order to reduce this very painful psychotic symptomatology we propose to increase the medication by 200 mg. I thought that we were all in agreement with this strategy. That said, if as you say, the treatment is becoming the problem and not the solution, we should take this up at our next meeting. Chris can ask to reopen the issue of the medication with Dr. ‘B’.”

So, according to Dr. ‘L’, Chris still suffered from “very handicapping auditory hallucinations.” This was Dr. ‘L’’s pessimistic view of schizophrenia. This very painful psychotic symptomatology “glass half-empty” vocabulary was a continuous downer. We only heard the bad news from Dr. ‘L’. Bad news didn’t help his patient’s parents cope. What good did this kind of attitude do? And he still hadn’t fixed the problem. Ian and I believed that there was no way that raising the medication was going to fix anything.

Somehow we prevailed and the medication was raised only 100 mg. Dr. ‘L’ acknowledged that, at the end of the day, Chris’s loyalties would be to us and it was useless for him, Dr. ‘L’, to argue the point. Ian and I held the key to the drug cabinet after all. It had taken us two years to fully appreciate this point. I wished that Chris was able to be in charge of his treatment rather than be pushed around, but it was unrealistic. Chris was ill. In the acute stages, someone else had to make the decisions for him. In the later stages, the authority of his parents and his doctors overwhelmed him. He was torn and he was also medicated. In addition, he was understandably afraid that lowering the medication would bring his psychosis back. He didn’t have enough energy, intellectual or otherwise, to do his own research, to learn to rely on his own intuition, and to fight his way out.

Fleetingly improvised men

Despite the benefits that I had observed in Chris from the assemblage point shift, Chris continued to present a poor clinical image at his day program. In early June 2006 at our monthly meeting, I argued the never-ending medication point once again with Dr. ‘L’ in the presence of Ian and Chris. I was getting that “please, dear” look from Ian, but I persisted.

Suddenly, in the midst of our discussion, Dr. ‘L’ did exactly as I expected he would that day. He was determined to demonstrate to us why Chris’s medication needed to be raised. He focused his gaze on a point near the window where Chris’s gaze was wandering, and asked quietly and with evident dramatic flourish, “Chris, what do you see?”

“Uh, someone over there near the window.”

“Surprise, surprise,” I thought sarcastically. Chris was seeing people in the room who weren’t us. He was hallucinating. Instead of the term “hallucination” I like the term that Daniel Paul Schreber used to describe people populating the corners of his gaze. He called them “fleetingly improvised men.” To Schreber, these were “souls, temporarily given human shape by divine miracle”.

Dr. ‘L’ had caught Chris in the act, and waved this around as proof positive that he needed to have his medication increased. I knew Dr ‘L’ would pull this trick and I was prepared, sort of. Chris had warned us before our meeting that Dr. ‘L’ wanted to raise the medication. I would have preferred to ignore Chris’s wandering eye, but it was rather obvious. So, instead, I said, “Yes, Dr. ‘L’, but in the bi-weekly meetings with the other families involved in the program, it has been said that we shouldn’t pay undue attention to voices. Therefore we haven’t. Of course he hears voices and sees things. Isn’t that what schizophrenia is all about? It’s not for academic interest that we talk about voices in the bi-weekly meetings in the first place. The drugs haven’t prevented the voices, have they, so what good are they in Chris’s case?” What I would have loved to add, but did not, was that two years in Dr ‘L’s day program hadn’t fixed the voices either.

Alas, as I also predicted, we allowed Dr. ‘L’ to raise one of his two medications from 200 mg to 300 mg. Chris, after all, was acting more skittish than we had usually seen him in Dr. ‘L’s presence. It was hard to deny it, but the medications wouldn’t fix it. We were stuck in this clinical program for better or worse and it was now a question of humoring Dr. ‘L’ until we could execute a graceful exit strategy from the program and the stupid medications.

Daniel Paul Schreber, “Memoirs of My Nervous Illness,” New York Review Books Classics (January 31, 2000)

Making a fool of the doctor and everyone else

Dr. ‘L’ had, on more than a few occasions, hinted that Chris was making a fool of him and everybody else. Was Dr ‘L’ going further by suggesting that Chris was acting? I had wondered the same thing. Yet it is difficult to reconcile that someone is acting with what seems to be a genuine inability to snap out of it. Could Chris “play” at being normal if he wanted to?

In his brilliant work The Divided Self, R. D. Laing recounts the thoughts of Joan, a recovered schizophrenic. Here, Joan addresses the word salad of supposedly meaningless things that schizophrenics say: “We schizophrenics say and do a lot of stuff that is unimportant, and then we mix important things in with all this to see if the doctor cares enough to see them and feel them.”

Laing observes, “A good deal of schizophrenia is simply nonsense, red-herring speech, prolonged filibustering to throw dangerous people off the scent, to create boredom and futility in others. The schizophrenic is often making a fool of himself and the doctor. He is playing at being mad to avoid at all costs the possibility of being held responsible for a single coherent idea or intention.”
R. D. Laing, The Divided Self (New York: Penguin, 1990), 164.

Poetry and play reading

Before and after our visit to the shaman, Chris attended a daily outpatient program for young people with mental health problems. He was an enigma to the staff. During our monthly meetings with his doctor, it was difficult to convince him to lower Chris’s medications because Chris’s “clinical” presentation was so poor. Chris was fairly happy and moderately talkative at home, but assumed the role of a mental patient at the program.

My exasperation sometimes spilled over. “Chris, can’t you just fake it for once?” I would complain. “Dr. ‘L’ holds the keys to the insane asylum. You need his blessing to get him off my back and agree to lower the medications. He is GO. You have to pass GO to collect the two hundred dollars. Get it?”

No, Chris didn’t get it. He appeared not to be able to fake his way out of whatever it was that was keeping him labeled “hopeless” at the program. Dr. ‘L’ told us in our next meeting that the staff were instructed to treat Chris especially gently. He obviously considered Chris a “nut case,” although he didn’t use that word. Instead, he said that he and the other doctors thought Chris was very bright, but they just didn’t know what the problem was. He pointed out that Chris had difficulty using scissors to cut paper during art therapy. “But, you know,” said Dr. ‘L’ earnestly, “we are amazed he is very good in acting class.”

I realized that I didn’t care any more what kind of clinical impression Chris gave. Maybe the clinic was the problem, I thought. True, it didn’t look good not to be able to cut paper, but then why was Chris able to do these things and more at home? He could quite dexterously handle tools to help fix things around the house. Maybe there was something wrong with having to perform for others at a clinic, to be judged by those around you, and to be compared to an apple when you are an orange, or maybe even a grape. Whatever the clinic was doing, it wasn’t doing it for me or for Chris. I had seen enough by then to realize that inside an institution was possibly the last place anyone would get well.

I had internalized some messages that now guided my thinking. Message number one (from Dr. Hoffer): Nobody who relies on drugs alone will ever get well. Message number two (from Dr. Klinghardt): The root of schizophrenia is often found at the fourth (intuitive) level of healing; if the problem doesn’t clear with therapies aimed at the first (physical) level, look to level four.

Dr. ‘L’ suggested that we read Waiting for Godot, as Chris reminded him of that play. It was easy enough to see why—the meaninglessness, indecisiveness, and inertness in the play mirrored Chris’s existence. Thereafter, for a brief period, Ian and I enlivened our lives, which had become confined to our couch, our television, and a nightly bottle of red wine, with a little play acting. We certainly appreciated where Dr. ‘L’ was coming from on this one. Ian assigned everybody roles. Taylor was Pozzo; Chris was Vladimir; Ian, Estragon; and I was the narrator. Chris read his part like a seasoned professional. He stepped outside of himself for once. His face took on an enthusiasm and a flourish. The play was the thing for him.

After spending several evenings on Waiting for Godot, we switched to poetry readings. Each of us read a favorite poem. Chris, in a clear and confident voice, with evident feeling and from memory, immediately volunteered this poem by Robert Frost:

Some say the world will end in fire,
Some say in ice.
From what I’ve tasted of desire
I hold with those who favor fire.
But if it had to perish twice,
I think I know enough of hate
To know that for destruction ice
Is also great
And would suffice.

(Fire and Ice by Robert Frost)

I recognize this poem as a very appealing to a schizophrenic sensibility. Fire/ice, love/hate. Ambivalence and death with a dollop of guilt thrown in.

We had informally approached Level 4 through our play reading and poetry. I saw the positive effect this had on Chris. More of this approach was needed to appeal to what was going on in his mind. We had done all we could at the base level of vitamins and electromagnetic interventions. We had yet to approach level 4 formally through therapy.

Prince Charles and the Royal Family

Ten days later after our first visit with the shaman, Chris returned for a checkup. Although this second visit wasn’t strictly necessary, I was beginning to appreciate the journey as a way of preparing for the outcome. As expected, Chris’s assemblage point was whole and had remained where the shaman had repositioned it. Nonetheless, Chris got a top-up of diamond and carnelian on his chest only.

I decided that I would like to have my assemblage point put back into shape the old-fashioned way, using the shaman’s blow and crystal wands. Given my age and the strain I had been under, my assemblage point had predictably traveled up the panic and anxiety line to the right side of my chest. The shaman’s assistant asked me to stand with my back to him, tighten my sphincter, and hold my breath. Then he quickly thumped my right shoulder blade. I was caught off guard. Air was forced reflexively out of my lungs and I emitted a little squeak. So that was the famous shaman’s blow! I then hopped onto the table where I was handed a giant quartz crystal wand that I struggled to keep upright over my assemblage point while the transducer pumped emerald crystal vibrations through my wine soaked liver. I stayed in that ludicrous position for twenty minutes.

A couple of days before, Prince Charles had delivered a keynote address at the World Health Organization about his belief that national health systems should take more account of alternative treatments such as homeopathy and acupuncture. I remarked on this to the shaman, who confided that established Harley Street doctors in London were quite concerned these days because members of the Royal Family were now largely seeing homeopathic doctors and other alternative medical practitioners.

I mentally began adding up the alternative treatments Chris had undergone: colonics; acupuncture; vitamins and supplements; energy medicine, including the magnetic mattress and a magnetic bracelet; Emotional Freedom Technique; and assemblage point shift. On a scale of 1 to 10, if Chris was a 10 when he was first hospitalized, then I would have to say he was now about a 5, a 4 at the most. He just was not visibly normal, meaning that he seemed somewhat nervous, was not comfortable around people in large or small groups and was not able to motivate himself. I attributed a lot of this to the effects of the medications, which I believed kept him in an anxious state, but I didn’t attribute all of it to the medications.

I felt that we were on the right track with all the interventions we had done up until that point, but that there was still a missing X factor that had not been addressed. The good that the vitamins had accomplished this far were undermined by the still heavy doses of meds. I believed that the benefits of the assemblage point shift would reveal themselves over the next few months and hopefully lead to a complete cure. We weren’t there yet. I still had not tried to approach Level 4 of the healing pyramid in a formal way.

As the shaman predicted, Chris gradually began to express his thoughts and convictions more. It was subtle, but it became increasingly apparent in the next few months. He more frequently expressed his preferences and sometimes lingered to talk a bit more. What surprised me is that I also felt that I was becoming more real. I became even more direct and focused.

The observer

An important concept in quantum physics is the role of the observer. There is a famous hypothesis called “Everett’s many worlds theory” that builds on Niels Bohr’s Copenhagen theory that an action seen by an observer has more than one possible outcome. Everett’s theory holds that the universe splits when that action is taken (or even when an action is not taken).

Physicist David Z. Albert has put a slightly different spin on Everett’s theory, which I believe is very important to the understanding of schizophrenia. Albert maintains that the term “many worlds” is actually incorrect and that a description that leads to a better understanding is to call it “many viewpoints.” This is in essence the schizophrenic problem of ambivalence: holding two (or possibly) more opposing views in which the center cannot hold. It offers one explanation for Chris’s lifelong aversion to making a choice.

As a university undergraduate, I was an art history major, not a physics major. Physics is hard for me, as it is for most people, to wrap my mind around. The implications of quantum physics are still not well understood, even by quantum physicists. What I can say with some conviction is that an appreciation of schizophrenia will emerge in future from a further understanding of quantum physics and lead to new methodologies in treatment. For the compassionate observer, schizophrenia brings us closer to the knowledge that we are all subject to a supreme power in the universe, but a spark of that divinity is also within us.

To quote Hermann Hesse once more, modern science is in the Stone Age compared to the teachings of ancient Indian mythology. Ancient and indigenous peoples seem to have a better appreciation of multiple realities than modern people do. Indigenous people, such as the Toltec civilization from which Don Juan came, know that hallucinogens can deliver you to an altered dimension where extraordinary things can happen. Although he did not know the physics of the assemblage point, he knew what moving it could do.

It made perfect sense to me that Chris began experiencing altered realities or parallel universes at the time that his assemblage point was breaking up. The assemblage point is assembled in the womb in part by the vibrational energy of the outside universe. Altered states of awareness such as in schizophrenia and lucid dreaming may be indications that there are universes parallel to our own.

(See also “The Akashic field and synchronicity,” April 22, 2009)