The Alcoholism and Addiction Cure

On the surface, schizophrenia seems to have nothing in common with alcoholism and addiction, however I highly recommend reading the book The Alcoholism and Addiction Cure: A Holistic Approach to Total Recovery, by Chris Prentiss. For starters, the author doesn’t shy away from using the word “cure”. He doesn’t consider alcoholism or addiction either “incurable” or a “disease”. These are symptoms that are coping mechanisms that one has chosen in response to life’s pain. Medical professionals who refuse to use the word “cure” in the context of certain mental health problems deprive people of hope and virtually guarantee that their problems are forever managed, never cured.

Mental health professionals are being disingenuous when they say that the cause of schizophrenia or alcoholism or addiction is unknown. Some people will stop right there and think to themselves, “well, if a doctor says this, there’s not point in my looking any further.” It is true that there is no one neat scientific explanation that can explain away the cause, but that doesn’t mean that a cause or causes cannot be found. Chris Prentiss makes a clear cut case for finding the cause of the pain by looking at the problem through the prism of the family story. Through my own research and willingness to undertake psychotherapy, I now have some insight into the cause(s) of my son’s problems. The causes are both psychological and physiological. I have developed a working theory that makes sense to me. I may be entirely wrong about what the real causes are, but it doesn’t really matter because I have noticed whatever we are doing seems to be working. I can empower healing in my son by changing the way I relate with him, by showing conviction that he will recover, and by understanding that his problems have a context.

Chris Prentiss eventually came to realize that his son’s descent into alcoholism and addiction was due to the son’s deep rooted anger with his father. The family background that he describes in his book provides a plausible explanation for this outcome. Many people will protest that everybody is angry with their father (or their mother) and that most people who are angry with a parent don’t descend into drug addiction. Well, actions do make sense if you care enough to pay attention. There is a logic to life.

Why schizophrenia is not a disease

The mistaken and unhappy notion that a man is an enduring unity is known to you. It is also known to you that man consists of a multitude of souls, of numerous selves. The separation of the unity of the personality into these numerous pieces passes for madness. Science has invented the name schizomania for it.

I do not believe there a pathological disease called schizophrenia. If people labelled schizophrenic really have a disease, it begs the question, why aren’t neurologists overseeing their care? The state called schizophrenia often strikes the gifted, the sensitive, the creative – people struggling to express something about their world that others fail to see. I began to understand and appreciate the journey my son was going through when I turned to literature for the answers that Western science seemed unable to provide.

Well, okay, I turned to Hermann Hesse and Google for many of the answers. For Hesse, schizophrenia can be a transformative process.

Demian is about a very specific task or crisis in one’s youth, which continues beyond that stage, but mostly affects (sic) young people: the struggle to forge an identity and develop a personality of one’s own.

Not everyone is allotted the chance to become a personality; most remain types, and never experience the rigor of becoming an individual. But those who do so inevitably discover that these struggles bring them into conflict with the normal life of average people and the traditional values and bourgeois conventions that they uphold. A personality is the product of a clash between two opposing forces: the urge to create a life of one’s own and the insistence by the world around us that we conform. Nobody can develop a personality unless he undergoes revolutionary experiences. The extent of those experiences differs, of course, from person to person, as does the capacity to lead a life that is truly personal and unique.

1. Hesse, Hermann, Steppenwolf, Bantam Books, 1974
2. Hesse, Hermann, Soul of the Age: Selected Letters of Hermann Hesse, 1891-1962

The Diagnostic and Statistical Manual of Mental Disorders

A friend handed me an article by Alex Beam, “Who’s Crazy Now?”, that appeared in the Boston Globe (Tuesday, July 28, 2009). It is a criticism of the making of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), and relates the usual criticism about the proliferation of medical diagnoses for normal human emotions, habits and bodily functions (e.g. nicotine dependence and premenstrual syndrome, to name two). It makes the very good point that the losers in this trivialization of mental disorders are the truly mentally ill, who would probably love to exchange places with the merely jet lagged or those undergoing nicotine withdrawal.

The article, while criticizing the marginalization of psychiatry as a profession, has inadvertently shown where exactly psychiatry should be headed if it wants to grow in stature with the public. Well, let me amend that. It shows how psychiatry could reposition itself to feel good about itself. Modern psychiatry appears to be largely about status and not about the people truly in need of its services.

The writer says that adding new so-called mental illnesses is “a naked land grab by a profession threatened with marginalization by biochemical research”. Wrong. Biochemical research has not made mentally ill people suddenly well. There is no threat that I can see from biochemical research.

In referring to the last edition of the DSM, published in 1994, blogging psychiatrist Dr. Daniel Carlat has this to say: “The idea was that in 20 years the science would have progressed to where it had hard scientific and biological markers for diagnoses, it just hasn’t happened. … The lack of biological markers to help us diagnose has made us feel in some way inferior to other medical professionals, as if we were not real doctors, because we don’t base our decisions on hard science.”

Modern psychiatry, feel inferior no more. There are no biological markers and there never will be. Mental illness is largely
p-s-y-c-h-o-l-o-g-i-c-a-l. Modern psychiatry has somehow missed this fundamental point. Take some motherly advice: Hold your head up high and as a profession, get back to doing what you should have been doing all along, which is treating people with serious mental disorders, and gasp, even empowering cure in them. Psychiatry is an art, not a science. Enjoy it for what it is and rid yourself of those who are unskilled in the art of understanding human beings. Let them be brain surgeons or neurologists. Psychiatry is needed, but has turned its back on the seriously mentally ill and their families, whose lives are in turmoil.

I briefly followed a blog by a psychiatrist, and stopped, because all he could write about was insurance and billing. I just bet his waiting room is filled with seasonal affective disorder (SAD) patients. If he has time to blog, which many psychiatrists seem to be doing, he is overachieving and hasn’t got time for the people who really need him.

The shopping cart

The left coast is chock-a-block full of peculiar people. My word! A supposedly HIV infected guy approached me on the street in Vancouver. Uh, oh, I thought, here comes the pitch. And what a pitch it was.

“Excuse me,” he began, “Thank you for at least speaking with me. Most people would not. Do you know that you look like the ex-wife of that billionaire whose last name is – I can’t think of it but it begins with a ‘T’.”

“You mean, Ivana Trump?” I gushed. I looked over at Ian, who is definitely not The Donald. “Ian, give this good man five dollars.”

Watching The Soloist on the plane to Vancouver was a great opening act for what was to come. The running theme of the Vancouver and Victoria leg of our August vacation was the shopping cart. At one point in the movie, Nathaniel Ayers refuses to leave his shopping cart behind when he is invited to give a solo concert.

The shopping cart would be an excellent place to begin to learn to treat schizophrenia holistically by understanding what is essential for the individual’s sense of survival, which surely must have something to do with his or her past. To me, the shopping cart represents life’s laundry. Everything that is important to the person is found within. The cart is wheeled everywhere, often with a plastic bag attached to pick up bottles, which presumably are redeemed for money.

Vancouver, being a laid back west coast city with good weather, has lots of street people driving life’s laundry around. I wonder if social service workers have bothered to ask them, piece by piece, what their life is about?

In Victoria, Ian and I were given an interesting perspective on street life by an old friend of Ian’s who has had a reversal of fortune. Jim is now out there with the best of them, “binning” as he calls it. He is in hot competition with Victoria’s street people for bottle collection and redemption. He waits until after dark, when no one from his previous life will see him, and then heads to the neighborhoods where he knows he can get the most bang for the buck. As we drove around Victoria’s streets in broad daylight, Jim gave a thumbs up to a few guys and gals pushing shopping carts, and occasionally pointed out that so and so over there was his main competition for that tax free income.

I know a lady from work who, judging from her appearance and quirks, has extreme mental health issues, but she plays the game of life, none-the-less. She walks to and from work dragging a shopping trolley, but is also occasionally seen trundling a piece of luggage to and fro. She sports bright red earmuffs when it’s not even cold outside. To talk to her, she seems normal enough, but her appearance and that trolley set her apart. I wonder what is so important to her that she takes it with her on a daily basis.

I know nothing about her, whether or not she has received treatment for mental health in the form of psychotherapy and/or medication. I suspect, because of her age, that she had not spent a lot of time in psychotherapy. It has only been relatively recently that psychotherapy for schizophrenia is promoted as a treatment that can work for schizophrenia. Since the advent of the typical (first generation) antipsychotics in the 1950s, the benefits of psychotherapy have been downplayed in the rush to pharmaceuticalize treatment. Four years ago when I began my search for other options beyond simply medications, the standard view put out by pharmaceutical companies and the big mental health organizations was that psychotherapy was not considered helpful for schizophrenia.

I am still unclear, from watching The Soloist, how that hospital/shelter, whatever it was that the patients milled outside of, was helping the street people it was supposed to be helping. How about starting with some individual psychotherapy? How about talking with them about what the contents of their shopping carts mean to them?