Holistic Recovery from Schizophrenia

Robertson Davies: On doctors and psychiatry

Robertson Davies is about my all-time favorite author. If you haven’t read any of his books, you should give yourself the pleasure. When I think of quotable authors or celebrities, he’s right up there with Carl Jung. In fact, I can’t think of any book that he has written that is not intellectually deep, easy to read and laugh out loud funny.

Background
In the 1940s, when Davies, author of the Deptford Trilogy and What`s Bred in the Bone, was publisher of an Ontario newspaper, he invented Samuel Marchbanks to comment on and satirize Canadian life in a short column. Marchbanks disappeared in the 1950s when his creator turned to writing plays. By the time Davies made his name in 1970 with Fifth Business, the first of the Deptford books, Marchbanks had long since sunk into retirement at his favorite haunt, the Crank and Schizoid* pub in Toronto.

Quotes

“Now, very few [physicians] are men of science in any very serious sense; they’re men of technique.”

— Robertson Davies, Conversations

“I was embarrassed to be such a fool in a situation that I had told myself and other people countless times I would never submit to — talking to a psychiatrist, ostensibly seeking help, but without any confidence that he could give it. I have never believed these people can do anything for an intelligent man he can’t do for himself. I have known many people who leaned on psychiatrists, and every one of them was a leaner by nature, who would have leaned on a priest if he had lived in an age of faith, or leaned on a teacup reader or an astrologer if he had not enough money to afford the higher hokum.”

— Robertson Davies, The Manticore

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*Rossa’s note: Fictional pub frequented by psychiatrists and Marchbanks, hard by the present day Canadian Centre for Addiction and Mental Health (CAMH)

A banner day but there’s work to be done

Today is my 500th blog post, and I was planning to mark this auspicious occasion by being statesmanlike and uplifting. However, real life intervenes and there is always some article or e-mail that cries out for my critical comments. Two have come my way, one from the New York Times and one from my perennial source of schizophrenia disinformation, namely NAMI.

The New York Times article on anorexia nervosa prompts me to bang on about the way schizophrenia is seen as a “special case” in our Western society, apparently way different than anoxeria nervosa, which appears to have family causes. The article refers to anorexia nervosa a “mental illness” and discusses it entirely in terms of community and family pressures. No mention of medication in this article.

As a teenager, Naomi Feigenbaum developed bizarre eating habits that had nothing to do with Jewish dietary laws………………….Young Orthodox women are also expected to conform to a rigorous code of conduct, with few outlets for rebellion. They are expected to be chaste until marriage and do not date until they start looking for a husband. Even gossip is considered a sin.

Your child and mine started having equally bizarre habits when they were teenagers or in their twenties, which I fully suspect is rebellion, but apparently schizophrenia is impervious to the kind of psychological understanding that this article promotes.

Then there’s NAMI, always quick to inject the need to medicate and oblivious to the fact that the medications your doctor gives you are prescription drugs and they are addictive. I couldn’t dream this stuff up if I tried. I’m so glad NAMI is there to reassure stupid, hysterical mothers.

The following is an account from a NAMI Helpline associate:

“I spoke with a person this morning who was crying because her 26-year-old child with mental illness had been in and out of hospitals and was refusing to take her medications, but also had a prescription drug addiction.

I let her talk for a while and when she calmed down, I told her about NAMI progams and support available in her local community. I also shared support options to help with addiction issues.

By the time we got off the phone, she stopped crying and thanked me, saying that she was so grateful that I listened and that she had learned so much about the various support options available to her.”

Schizophrenia and epilepsy

From Wikipedia

Ladislas J. Meduna (1896–1964) was a Hungarian neurologist and neuropathologist noted for his development of shock treatment for persons suffering from schizophrenia.

Meduna was born to a well-to-do family in Budapest, Hungary, in 1896. He studied medicine in Budapest from 1914 to 1921, his studies being interrupted by military service in the Italian front from 1915 to 1918.

He was appointed to the Hungarian Interacademic Institute for Brain Research, also in Budapest. He worked under the direction of Karl Schaffer. He studied the neuropathology of the structure and development of the pineal gland and of microglia, lead poisoning, and avitaminosis. In 1927 he moved to the Psychiatric Institute with Dr. Schaffer and began clinical and research work in psychopathology.

Meduna’s interest in treating schizophrenia began with observations that the concentration of brain glia varied among patients who died with epilepsy (more glia than normal) and those with schizophrenia (less glia than normal). He thought that the inductions of seizures in patients with schizophrenia would increase the concentration of glia and relieve the illness. The concept was supported by reports that the incidence of epilepsy in hospitalized patients with schizophrenia was extremely low; and that a few schizophrenic patients who developed seizures after infection or head trauma, were relieved of their psychosis.

He sought ways to induce seizures in animals with chemicals; after trials with the alkaloids strychnine, thebaine, coramin, caffeine, and brucin, he settled on camphor dissolved in oil as effective and reliable. For a population with severe schizophrenia, he moved from Budapest to the psychiatric hospital at Lipotmező, outside Budapest. He began his dose-finding experiments on January 2, 1934. He was able to induce seizures in about 1/3 the first subjects. Nevertheless, three of the first 11 patients had a positive response, encouraging his work.[See Gazdag et al., 2009.] In his autobiography, he recalls the patient who began his treatment on January 23, 1934 in a severe 33-year-old catatonic patient. After just 5 treatments, catatonia and psychotic symptoms were abolished. Increasing his cases to 26 patients, Meduna achieved recovery in 10 and improvement in 3 more.

A major factor in Meduna’s achievement was his selection of patients—9 of the first 11 patients were catatonic. Catatonia is a syndrome that is remarkably responsive to induced seizures. The serendipity that catatonia was considered schizophrenia made his discovery possible.

Early in his work Meduna replaced camphor with pentylenetetrazol (Metrazol), an intravenous agent that induced seizures immediately compared with the long delay of 15 to 45 minutes after intramuscular camphor.

He first published his results in 1935 and then his major text in 1937. Die Konvulsionstherapie der Schizophrenie describes the results in 110 patients. Of these patients about half recovered. The results were much better for patients who were ill less than a year compared to those who had been ill for many years.

His results were quickly reproduced in many other centers around the world and this form of therapy became widely used and recognized as the first effective[citation needed] treatment for schizophrenia. (A parallel development was insulin coma therapy.) A more facile form of induction of seizures, using electricity instead of chemicals, was developed by the Italian psychiatrists Ugo Cerletti and Lucio Bini. They treated their first patient with ECT in May 1938 and by the mid-1940s, electricity had replaced Metrazole as the induction agent.

Meduna also developed carbon dioxide therapy. The patient had to breathe a mixture of 30% carbon dioxide and 70% oxygen until becoming unconscious, the treatment being repeated several times weekly. Although it was effective in relieving obsessive-compulsive disorders[citation needed], it was not as effective as convulsive therapy, and it was abandoned.

With the increase of anti-semitism and the rise to power of National Socialism, Meduna emigrated to the USA in the following year (1938), to become Professor of Neurology at Loyola University, in Chicago. One of his last contributions to psychiatry was the study of confusional and dream-like states in psychoses (oneirophrenia). He was also a founder of the Journal of Neuropsychiatry and a President of the Society of Biological Psychiatry. After the war, he moved his research to the Illinois Psychiatric Institute, where he worked until his death in 1964.

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File under miscellaneous

Chris’s voice has progressed  lower again.  I noticed a deepening a couple of weeks ago after he started Sahaja Yoga meditations. The first time I noticed his voice had dropped a bit was after he studied the Alexander Technique, and then again after undergoing Tomatis therapy.

But, what exactly does a deeper voice mean in the context of a diagnosis of schizophrenia?  In my non-scientific thinking, I associate the lowering of the voice with vibrations, chakras and  improved body/mind connection. A lower voice to me implies Chris is becoming more grounded. I have been focusing on the body/mind connection for quite a while and that’s the reason I pushed him into exploring these therapies in the first place. Well, actually, he didn’t need any encouraging for the Alexander Method. He absolutely loved it. 

There are all kinds of minute observations in schizophrenia recovery that a mother worth her salt should be able to spot. What it all means is something else.

Equus

A few weeks ago, Chris and I went to our local English language theater production of Equus. Playwright Peter Shaffer’s 1973 play is about a psychiatrist in a provincial British psychiatric asylum, trying to decipher the mystery of why a seventeen year old boy blinded six horses in a stable.

The script is simply brilliant, the stage set is minimal. The play is largely a dialogue between the psychiatrist and his patient.

Equus is somewhat dated. The psychiatrist, Martin Dysart, seems to have all the time in the world to entertain impromptu visits from the boy’s parents and the stable owner. Today’s hospital psychiatrists are always in a rush and aren’t too keen on drop-in visits. Neuroleptic medications are never mentioned in Equus, neither are they used. The boy’s parents willingly share with the psychiatrist their interpretation of events that might have traumatized their son, in the hopes that this will help him heal his troubled state of mind. Today, parents are encouraged not to go down the line of thinking that quite possibly the family environment has an impact.

I wonder if anyone else who has seen the play has a complaint about its portrayal of schizophrenia. Martin Dysart knows his client is troubled, but it doesn’t occur to him that his client is “schizophrenic.” He casually and disparagingly mentions a fifteen year old schizophrenic patient of his but there is no connection in his mind of schizophrenia with his present patient. Schizophrenia, even to Dr. Dysart, seems to be a special case. My word, the boy was mute when he arrived at the hospital, retreated into singing jingles from television and radio commercials when he got anxious, and had whopping fantasies about horses and Jesus in shackles.

Martin Dysart did just what R.D. Laing and Loren Mosher recommended by done for schizophrenia. He looked for trauma in his patient’s background, he talked to him, he didn’t use neuroleptic medications. The final scene is one of catharsis for the patient.

I don’t really care about labels, but I do care about the ingrained attitude in the public’s mind that people with a diagnosis of schizophrenia are not “curable.” The boy, Alan Strang, seems “schizophrenic” to me, so I question what Dr. Dysart  thought he had for a patient. How naive could the doctor have been? Perhaps the playwright Peter Shaffer labored under the delusion that schizophrenia was incurable, so whatever Strang had, and had “cured” by the psychiatrist, couldn’t be schizophrenia.

Chris’s reaction to the play was interesting. He remarked that whatever fantasies he is deeply ashamed of, are really quite mild compared to what he observed in the play. This thought was liberating to him.

Faith healing does work

Don’t miss this interesting article from CNN. My only quibble is that it portrays schizophrenia as a  condition impervious to faith healing, ie there is no point in amateurs trying to heal schizophrenia! Nonsense, I say. When I looked around at the other mental health articles on the left sidebar of the CNN site, I grasped that they seem to be infomercials in favor of mental health labelling and medication.

iReport shows how mentally ill in India turn to faith healers

Christopher Davis, an anthropologist at the University of London’s School of Oriental and African Studies (SOAS), said traditional healers can play a role as mental health providers.

She contends that there is epidemiological evidence to the effect that people with mental health issues actually fare as well in communities where there is less medicalization of their condition.
“Anthropologists would argue that regarding faith healers as a less appropriate choice than physicians is a reflection of our own faith in medicine rather than in community as a way of finding a remedy for life’s problems,” she said.

NamiDearest nails drug market creep

The bipolar dog’s heartbreaking dilemma

What I find so odious about the National Alliance on Mental Illness (NAMI) is its whole-hearted embrace of the pharmaceutical treatment of mental illness. It is so enamored of pharma that it is constantly on the look-out to help its good friend find new customers. The childhood bipolar market is saturated, but now there are PETS! And who’s to say that Fido isn’t bipolar? You know you’ve been ignoring his behavior for too long, thinking he’d grow out of it. But, there’s good news on the horizon.  Bipolar dogs face enormous challenges, including society’s stigmatization and the discrimination that results from these prejudices. Substance use counseling, housing, work and educational skill development are among other supports frequently required to maximize your pet’s prospects for a higher functional level.

NamiDearest inspired today’s post.

Even our furry and feathered family members can have a mental illness

Many of us think of our pet as just another member of our family, so why shouldn’t we treat them like we treat our own children? It makes sense that if mental illness runs in families, our pets could become mentally ill as well. Indeed, this is what veterinary psychiatry has discovered. Mental illness in pets is on the rise!

“Dr Carter, a leading animal psychiatrist, said animals were being put on anti-depressant medication in increasing numbers as vets and owners became more aware of the signs of mental illness. “We use a lot of drugs like Prozac and other anti-depressants and Valium,” Dr Carter said.”

“Not only dogs can develop mental disorders. Dr Carter said she had treated cats, horses and even birds. Birds being kept as pets quite often display signs of mental illness. The most common sign for birds with mental illness is plucking out their feathers. There are lots of reasons a bird might pull its feathers out, but anxiety can be a cause for it.”

Read on to learn more about signs of mental illness in the family pet. Please do not further stigmatize our beloved pets by laughing at the images you will see.

Abilify’s chameleon-like behavior

Here’s a scenario concerning the ever expanding market for neuroleptic medication. Perhaps some of you have ideas to contribute to this scenario.

Abilify originally was approved by the U.S. Food and Drug Administration as an antipsychotic, and rather quickly gained approval as a treatment for depression and autism. I am now thinking of Chris, if I have to use a label for him at all, as “depressed,” and no longer “schizophrenic” thanks to Bristo-Myers-Squibb’s (BMS) amazing Abilify trick, aided and abetted by its good friend, the FDA.

BMS has now freed us to pick and choose our label based on the many diagnoses its product is treating. Technically, since Chris is on Abilify only, he is not clinically depressed, because to meet this standard he would have to be also on an antidepressant, as Abilify is only approved for unipolar depression if used in conjunction in conjunction with an antidepressant. I could begin thinking of Chris as bipolar, since bipolar doesn’t seem to carry the same stigma as “schizophrenia.” I sincerely doubt Chris is autistic, so autism is a non-starter. I like the idea of “depressed” because anyone can start off on both Abilify and an antidepressant and then drop the antidepressant. Can Chris now go to his doctor and get his original diagnosis changed, given that he was once on an antidepressant and weaned himself off it? I think, judging from the Abilify, that this is a valid conclusion to draw. On what basis could a doctor refuse to change his original diagnosis?

But what does this mean for the BMS pipeline? The company is going to have to reposition schizophrenia, once again, as horrible, devastating, and, most importantly, “unique.” Will it begin to trash Abilify as no longer useful for schizophrenia while simultaneously introducing a new improved drug, e.g. “Rehabilify” marketed only for schizophrenia?  What new “diseases” will replace schizophrenia market for Abilify?

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Aripiprazole (pronounced /ˌɛərɨˈpɪprəzoʊl/ AIR-i-PIP-rə-zohl; brand names: Abilify, Aripiprex) is an atypical antipsychotic and antidepressant used in the treatment of schizophrenia, bipolar disorder, and clinical depression. It was approved by the US Food and Drug Administration (FDA) for schizophrenia on November 15, 2002, for acute manic and mixed episodes associated with bipolar disorder on October 1, 2004, as an adjunct for major depressive disorder on November 20, 2007 and to treat irritability in children with autism on 20 November 2009.[1][2] Aripiprazole was developed by Otsuka in Japan, and in the United States, Otsuka America markets it jointly with Bristol-Myers Squibb. (Wikipedia)

My ashram

Chris and I attended our first Sahaja Yoga meditation last night. I couldn’t help shaking my head; the venue was within spitting distance of where Chris spent two years attending a psychiatric outpatient program. Two words that come to mind about that program are “expensive and lame.”  It looked upon psychic distress as mainly a medical problem, and of course, medication management was a big part of the curriculum. Impressive, if you judge these things by the number of staff with professional accreditations. The problem is, the cooking classes, the light ergotherapy exercises (bringing your knees to your chest while lying on the floor), the forty minute acting classes, just don’t do the profound lifting needed to get to the root of psychosis.

If I were going to run a program, here’s what I’ve have on the menu. Yoga classes, meditation, assemblage point shifters, Family Constellation sessions, music, etc. The emphasis would be on vibration. There were be classes on nutrition and vitamin support. The rented facilities would look more like an ashram and not at all like a hospital outpatient program. This kind of therapeutic outlet would be cheap because it wouldn’t be professionalized. It would be staffed mainly by volunteers.

I’m not very familiar with meditation, having done it sporadically with different teachers over the past few years. Sahaja Yoga meditation is different to the other meditations I’ve done, which tended to be more like “imagine yourself walking through a peaceful green forest and you come upon a crystal stream . . .” The aim of Sahaja Yoga is to immediately awaken the kundalini, which, with practice, eventually leads to self-realization. The technique is simple to grasp and self-realization doesn’t have to be attained after years of discipline. We’re all expected to notice improvements rather quickly in our well-being.

I have always been uneasy about the awakened kundalini. I’ve read that it is such a powerful force that amateurs have no business playing with it. I also thought it was something that you just don’t jump into. We jumped right into it last night. Chris and I went through our guided meditation in English in a separate room from the others who were carrying on in French. After we finished and our kundalinis were roused, we stepped into the main room where the rest of the group was busy fanning kundalinis and cleaning chakras. The air was flowing with kundalini arousal en masse.

Chris was enthusiastic about his experience. We both slept well.

Meditate instead of medicate

Chris got another “you’ve got to up your game” talk from me a couple of nights ago. This time, I strongly suggested yoga and meditation. My pushing yoga and meditation will come as no surprise to anybody reading my past two posts.

I’m getting a little tired suggesting things my twenty-seven year old son should already have thought about for himself, but there you are. I’m used to pushing and prodding, after all, I’m a wife. Lucky for me, Chris is usually appreciative of my motherly suggestions. Left to his own devices, he’d continue to read Marcel Pagnol in the original French, take voice lessons, cook our dinner, and be a generally fabulous and conscientious guy.  But, he has yet to earn a paycheck nor is he pursuing full time or part time studies. He’s going to have to up his game.

To move him to the next level, to get the next breakthrough experience, (he’s had several, all of which have upped his game in some way) I think introducing him to yoga and meditation is what is needed. We may not have to journey to Outer Mongolia for healing by shamans, we can take a mind and body journey right at home. Some of you might be offended that I would equate yoga and meditation to upping one’s game, but what is underlying this is the wish that Chris’s resilience continue to increase.

I gave Chris an assignment: Find three yoga courses that he might want to enroll in and check back with me by COB today. I told him I would take care of finding the meditation. On Sunday I went to a most interesting talk about a certain kind of meditation that made me realize that this may be what we are looking for. I’m going to a meditation tonight, and will see how it goes.