The benefit of institutions

Chris is out of the psychiatric hospital after three months and 10 days. This time around it was a different experience than when he was last hospitalized in the same institution for three months in the summer of 2004.

This time around I had warm fuzzies for the psychiatrist and staff. The atmosphere felt “homey”. Chris and his fellow inmates appeared much more functional to me than was the case before. We were moving up the food chain.

Although he is back on medications for the foreseeable future, I am no longer as uptight about the damage they are supposed to inflict. I have worked with a holistic psychiatrist for three years and I experienced how the other side of the drugs versus no drugs debate can be played out. It can be every bit as exhausting, demoralizing and propagandistic in its own way as what I experienced worrying about the damage that the drugs were doing. (See: The tyranny of vitamins – April 17, 2009.) At the same time, holistic/orthomolecular interventions take into account the personal history and biochemistry of the individual. For this reason alone, they are infinitely superior to meds. My position on the meds versus vitamins front now looks quite schizophrenic. In my own way I have become quite schizophrenic since schizophrenia befell Chris.

In the exit interview, Chris’s psychiatrist spoke warmly about Chris. He expressed a clear belief that Chris was evolving and that Chris will continue to evolve. I agree that Chris’s general future direction looks good, but not wanting to be a party pooper, I kept quiet about the niggling fear that Chris had merely gone underground for a while. No doubt the psychiatrist was also putting the best polish on the situation. Chris had been there long enough. There was nowhere to go but out. We discussed Chris taking life one baby step at a time in order to move onto the next level. We discussed letting him make his own decisions. During his worst periods Ian and I assumed that unwanted role. Chris has expressed an interest, in no particular order, in Buddhism and cooking classes. I was pleased to see that he pulled out an agenda during the exit interview and wrote down all his upcoming appointments.

The dreaded R words to the anti-meds folks are relapse and re-hospitalization. Re-hospitalization is seen as a sign of failure (relapse) and falling into the clutches of the drug lobby. I am now somewhat open to working with medications because (a) my husband is threatening to divorce me if I don’t support them (the gun to the head approach) and (b) because Chris has made progress over the past few years. I attribute this to the vigorous holistic interventions that he underwent during this period and the fact that we didn’t give up on him. The holistic interventions will continue, but I have “bought” the psychiatrist’s point that if, from time to time Chris needs a respite, the door is always open for shorter hospitalizations or overnight care on the road to good health. He suggested that this strategy shouldn’t be seen as a failure, but is more often a need for a sort of “regrouping”. The staff can offer help in this way. I nodded enthusiastically at the mention of short overnight stays. Although I fervently hope and pray that it doesn’t deteriorate to that point again, the idea of a little R & R away from Chris is very appealing.

First day back home, he was fine. Second day back, I wondered what Chris had been doing for three months in the hospital. He was acting pretty weird, possibly the voices, maybe not. The behavior always shakes me. This time around I promised myself that Chris was not going to get to me. I went to my room and closed the door, no longer wanting to be “helpful”. Let Chris come to me if he needs something or just wants to talk. At the end of the day, I broke my vow and instigated a little chat. Since Chris had still not filled the prescription that was about to run out, I asked him what exactly he was told at the hospital about the repercussions of not taking his meds. “Well, they just told me that I am supposed to take them every day,” he claimed. “And, what happens if you skip them or “forget” about them?” I prodded. He didn’t know. “I’m surprised that the doctors didn’t detail for you the physical consequences of not taking the meds as prescribed,” says I. “Being told to just take them every day is not as informative as spelling out the gut-wrenching head-clanging experience that you get by “forgetting” to take them.” I’m prepared to let Chris learn experientially on this one.

Reparenting and Jacqui Schiff

Another proponent of the bad parenting school of thought was social worker Jacqui Schiff, who took a number of schizophrenic young people into her household in the early 1970s to “reparent” them, using Transactional Analysis techniques that she had learned from Dr Eric Berne. All My Children, published in 1970, provides a graphic account of the struggles she and her husband went through in the process of reparenting. She is scathing about the failure of parents to send the right messages to their children, which, she claims, results in their subsequent development of schizophrenia. Despite the fact she is acquainted with the parents of her charges in only the most superficial ways, she feels qualified to pass judgment on them, while making the same questionable judgments in her reparenting that parents make in parenting. She is particularly harsh on the mothers.

This harsh view of the parents, and in particular the mother, was shared by many psychiatrists at the time, notably Dr. Loren Mosher, Dr. Leo Kanner and Dr. R.D. Laing. Unfortunately, blaming the parents played right into the hands of drug companies. Why do I say this? I say this because drug companies don’t blame the parents. Drug companies claim that schizophrenia is a matter of biochemistry, by implication not by bad parenting.

By labeling schizophrenia a brain disease, not a result of bad parenting, psychiatrists and drug companies have made it easier for parents to say, “Look, it’s not my fault my child has schizophrenia; my child actually has a brain disease.” They have also ensured fat profits for pharmaceutical companies for years to come by this particular logic. What parents, feeling bad enough about the situation, would want to believe that it was their fault, especially if they had raised other well-adjusted children?

At the same time, and this is important, why would parents prefer to believe that their son or daughter has a damaged brain? Why would anyone want to believe that they were somehow “damaged”? That idea is horrible. It is a hopeless view. It is locking the young person into a lifetime of misery and dependency on drugs. There are many websites devoted to showing computer images of the damaged schizophrenic brain. One such website shows pictures of early and late gray matter deficits in schizophrenia. “But”, proclaims the website, “while there is a significant loss of brain gray matter, this is not a reason to lose all hope.” (see link below) Yes, according to the website, these deficits may be reversible and scientists are hard at work on inventing a miracle drug that could potentially reverse these cognitive declines.

I began to appreciate these out-of-favor psychiatrists (and one social worker) after I decided that there was no way I was going to believe that Chris had a damaged brain. The more I read, the more I agreed with them. They were downright interesting. They weren’t trying to toe the politically correct line. They criticized the pharmaceutical industry and psychiatrists for entering into unholy alliances. For all of the emphasis on the pharmaceutical approach, patients weren’t getting much better and of course, there were the side effects. All of this struck a chord with me.

They seemed to be in favor of schizophrenia as giving added value to the world. R. D. Laing believed that schizophrenia was a creative process leading to spiritual and emotional healing and noted that other cultures view schizophrenia as a state of trance, which could even be valued as mystical or shamanic. Isn’t finding “value” in schizophrenia more likely to lead to healing?

I looked into Dr. Leo Kanner’s work again and realized that, as with much of our sound-bite-obsessed culture, even in 1960 his remark about refrigerator mothers was probably blown out of proportion. Dr. Kanner had gone on to say something that shows an understanding that the origins (he was referring to autism) might go further back than the parents have control over. “The children’s aloneness from the beginning of life makes it difficult to attribute the whole picture exclusively to the type of early parental relations with our patients…We must, then assume that these children have come into the world with innate inability to form the usual biologically provided affective contact with people.” He then challenges the mothers to turn against the psychobabble of the contemporary psychiatrists in favor of their (the mothers’) innate common sense: “[R]egain that common sense which is yours, which has been yours before you allowed yourselves to be intimidated by would-be omniscient totalitarians.” Well said, Dr. Kanner!

Your doctor is not your friend

So, it seems simple, doesn’t it? You take your vitamin and mineral supplements, and within a few weeks or a few months you are back to normal.

There are many complicating factors preventing what I thought was supposed to be a fairly straightforward thing. Chris has been taking his supplements now for four years. He definitely seems more normal, but he is still not paying income tax and neither does he seem interested in making this a goal.

If Dr. Hoffer was as successful as he was in treating patients, now fifty years on, why is schizophrenia still viewed as “chronic”? Or, more personally, why aren’t you well?

I will throw out three ideas. One is your doctor. Two is you. Three is the competition. These will be discussed in separate posts. I’ll begin with your doctor.

Your doctor probably doesn’t believe in vitamins and may do everything he or she can to undermine your desire to introduce these into your personally designed program of total health.

Chris’s psychiatrist was one such person. To be fair, the psychiatrist was part of the institution in which Chris was enrolled as a day patient. So, it wasn’t necessarily the doctor who disapproved of vitamins. It was the institution that saw it as a threat to its way of doing business. The institution has a program to help young people in their twenties reintegrate back into society by giving them a focus for their day, therapeutic activities and medications. Recreational drugs were forbidden (rightly so) for those enrolled in the program but medications were not just encouraged, they were mandatory.

When naive me let the doctors know that Chris was taking vitamins, at first they said this was fine with them. They said the usual stuff like “vitamins aren’t proven useful, but they are not really harmful either.” When I began to notice improvements in Chris (usually I noticed the improvements – the doctors did not) I asked that Chris’s medications be lowered. The stage was set for conflict. If Chris had a problem with incontinence, for example, I blamed it on the medications being too high, they blamed it on the vitamins. If Chris was more out of it than usual, the doctors said his medication needed to be raised or even changed. To this I countered, “well, since he’s on medications, why is this even happening?” So then they would earnestly talk about damaged brains and the need for medications to protect the brain from further deterioration. I’m sure you have seen pictures of the damaged schizophrenic brain. It looks like a blue bicyle helmet that has had pink paint dumped on it.

One of the hardest parts of all this is having a spouse/family member who disagrees with your approach, or who may be supportive but is understandably worried about being wrong. None of us operates in a vacuum. This makes unilateral action on using vitamins challenging. The doctors and pharmaceutical companies exploit this, believe me, by terrorizing us about the damaged brain.

So, we try to work with vitamins in a climate of fear. It would have been wonderful if Chris were never on medications and if he had started on vitamins as soon as we thought something was wrong. But we didn’t know about vitamins or schizophrenia at the time, and we believed the doctors when they told us that medications were not only effective, but necessary in treating schizophrenia.

There is tyranny in the vitamin approach, too. I’ll save my comments on this for another day.