There is hope for even chronic cases of “schizophrenia”

Ron Unger is the best blogger I know who can decode schizophrenia to the outside observer and offer  healing words of wisdom. His most recent post is a must read. It’s a lengthy look at what Carl Jung believed about schizophrenia. For people who want to know if there is hope for people with ” schizophrenia,” here’s what Jung wrote:

In regard to the latter (i.e., severe cases), Jung stated: “It would be a mistake to suppose that more or less suitable methods of treatment exist. Theoretical assumptions in this respect count for next to nothing. Also, one would do well not to speak of ‘methods’ at all. The thing that really matters is the personal commitment, the serious purpose, the devotion, indeed the self-sacrifice, of those who give the treatment. I have seen results that were truly miraculous, as when sympathetic nurses and laymen were able, by their courage and steady devotion, to re-establish psychic rapport with their patients and so achieve quite astounding cures” (p.265).

Jung then addresses certain countertransference issues:

“But even so one can bring about noticeable improvements in severe schizophrenics, and even cure them, by psychological treatment, provided that one’s own constitution holds out [in my own experience, I have had situations where I continued the long-term psychotherapy of several patients in inpatient state hospital settings, later transferred into my practice, in which I was physically attacked, reported to have sexually molested the patient , etc, to very positive outcomes, e.g., to the point where family thought their family member was originally misdiagnosed as schizophrenic, never having to return to the state hospital after many years of residing there, etc]. This question is very much to the point, because the treatment not only demands uncommon efforts but may also induce psychic infections in a therapist who himself has a rather unstable disposition. I have seen no less than three cases of induced psychoses in treatments of this kind” (pp. 265-266).

Misunderstood and then misdiagnosed

I do most of my thinking for this blog while I’m walking to and from work. The motion and fresh air stimulate my thoughts. As I walk, I ruminate about something I heard or saw the day before.

 The bipolar disorder satire that has been seen on so many blogs, the one where the computer animated woman keeps telling the shrink how crummy she feels on the medication and he keeps repeating that she needs the medication because she has “the bipolar disorder,” and it goes round and round from there. She tells him that she was feeling very upset because of a family tragedy when she was admitted to hospital and he says “that’s the bipolar disorder.”

What interested me recently about this clip was that the patient says she is on 10 mg of Abilify for “the bipolar disorder.” A few months ago I half jokingly told Chris (on 5 mg Abilify) he was depressed, not schizophrenic, because I discovered that Abilify was now being prescribed as an add-on treatment for depression. But he can also be bipolar, if that’s what he prefers, because Abilify is also for bipolar disorder. (A real wonder drug!) Who’s to say Chris isn’t bipolar? When he was first admitted to hospital, the doctors gave him only a 25% chance of being bipolar, but, as we know, doctors are often wrong, especially when it comes to psychiatric diagnoses.

Of course, I am being facetious, because the labelling is meaningless in the first place, but the blurring of diagnoses logically comes about because the same drug is used to treat supposedly different conditions. This is an open invitation to pick the diagnosis you would prefer to have. If a choice has to be made, wouldn’t a patient want to join the higher status group of people like Britney, Catherine and Mel, who supposedly don’t have schizophrenia, they have “the bipolar disorder.” Is it logical to claim that if you are no longer on Abilify, you no longer have the bipolar disorder/schizophrenia/depression?

Along the same lines of my muddled thinking on Abilify, here is an excerpt from Pamela Spiro Wagner’s blog, which relates how her friend  assumed that he was schizophrenic, based solely on the fact that he was prescribed Trilafon. The doctors never questioned this diagnosis once Joe told them what he was. They accepted what Joe told them as fact, without doing their own thinking. This is a very sad story, and unfortunately, it’s an all too frequent one.

I believe that Joe was misdiagnosed for many many years with schizophrenia, when in fact he had had Asperger’s from childhood. Now, that’s a long story in itself and though I could make a case for it, I cannot prove it. But I am not the only one who knew him well to notice that he never once exhibited signs of psychosis or even real delusions or true paranoia. Furthermore, from what I gather, the only reason the diagnosis came about or “took” was because he was put on Trilafon by a well-known psychiatric incompetent who was later “defrocked” and when Joe looked the drug up in the PDR and read what it was used for, he concluded that that meant he must have schizophrenia. From then on, so his story was, he told subsequent doctors this diagnosis, and apparently they simply took it on faith. In fact, for all the years thereafter until his terminal illness of ALS, the one doctor he saw not only never questioned this, but also never even reconsidered his absurd concomitant Dx as bipolar, even though Joe clearly had one of the most placid temperament possible and certainly wasn’t the slightest bit moody. No one so far as I know ever even considered that there might be something else going on. Even when I once went with him to see his non-medical therapist, did she really seem even to want to think about the possibility, as if it might be too much trouble…Perhaps, though I cannot recall, it was too late, if in fact this was after Joe’s ALS diagnosis.

But as I said, that is a long story, and not being a doctor, I suppose I can’t make the diagnosis, except that as his closest friend, I do and I feel that a great injustice was done. Not only was he saddled with a serious psychiatric diagnosis, and a stigmatizing one at that, but that particular neuroleptic medication rendered him much too tired to work as an engineer. All his adult life that was what he really wanted to do. Work. But the drug sapped his stamina…Worst of all, although eventually on Zyprexa which helped what might have been poor social skills due to Asperger’s, after he had been on it for years it caused the diabetes that ultimately cost him his life.

So what is schizophrenia? I’ll let Jung have the last word here. These are actually two quotes. I have added the second shorter quote to show how to cure a schizophrenic. (I like how he adds “provided one’s own constitution holds out.” How true!)

But even so one can bring about noticeable improvements in severe schizophrenics, and even cure them, by psychological treatment, provided that one’s own constitution holds out [in my own experience, I have had situations where I continued the long-term psychotherapy of several patients in inpatient state hospital settings, later transferred into my practice, in which I was physically attacked, reported to have sexually molested the patient , etc, to very positive outcomes, e.g., to the point where family thought their family member was originally misdiagnosed as schizophrenic, never having to return to the state hospital after many years of residing there, etc]. This question is very much to the point, because the treatment not only demands uncommon efforts but may also induce psychic infections in a therapist who himself has a rather unstable disposition. I have seen no less than three cases of induced psychoses in treatments of this kind.

A schizophrenic is no longer schizophrenic… when he feels understood by someone else.

– Carl Jung

I have a small comfort zone, therefore I must be normal

If normal is becoming a shrunken pool due to overdiagnosis of mental illness, and alarming clinical psychologists like Til Wykes, I actually find this shock and horror rather amusing (especially coming from a psychologist.) Let me explain.

When you are on the outside looking in, in terms of what “normal” people call schizophrenia, you assume the person is mentally ill, because, really, the behavior can be off the charts weird. So “normal” people run away. They are so horror struck that they assume whatever it they are seeing and hearing can’t possibly be normal and they ask that someone (a psychiatrist) put a stop to this behavior immediately. This almost always involves using medications to solve the problem. However, medications don’t actually fix the problem, they just sedate the person and more often than not, those pesky abnormal thoughts are just waiting around to break through once more.

Just because you or I think we would never react so strangely to a problem, doesn’t mean that doing so is abnormal. Psychosis is a well-trod path. Venture out beyond your comfort zone of normal and you will begin to understand.

I wish to thank Beyond Meds for bringing this wonderful quote to my attention.

Anyone who wants to know the human psyche will learn next to nothing from experimental psychology. He would be better advised to abandon exact science, put away his scholar’s gown, bid farewell to his study, and wander with human heart throughout the world. There in the horrors of prisons, lunatic asylums and hospitals, in drab suburban pubs, in brothels and gambling-hells, in the salons of the elegant, the Stock Exchanges, socialist meetings, churches, revivalist gatherings and ecstatic sects, through love and hate, through the experience of passion in every form in his own body, he would reap richer stores of knowledge than text-books a foot thick could give him, and he will know how to doctor the sick with a real knowledge of the human soul. — Carl Jung

The Holy Spirit

Letter from Carl Jung in reply to Bill Wilson, founder of Alcoholics Anonymous, dated 30 January 1961, Kusnacht, Switzerland. Bill Wilson wrote a letter of appreciation to Carl Jung. “Very many thoughtful A.A.’s are students of your writings. Because of your conviction that man is something more than intellect, emotion, and two dollars’s worth of chemicals, you have especially endeared yourself to us . . . “

Dear Mr. Wilson,

Your letter has been very welcome indeed.

I had no news from Rowland H. anymore and often wondered what had been his fate. Our conversation which he has adequately reported to you had an aspect of which he did not know. The reason I could not tell him everything was that those days I had to be exceedingly careful of what I said. I found out that I was misunderstood in every possible way. Thus I was very careful when I talked to Rowland H. But what I really thought about was the result of many experiences with men of his kind.

His craving for alcohol was the equivalent on a low level of the spiritual thirst of our being for wholeness, expressed in medieval language: the union with God.*

How could one formulate such an insight in a language that is not misunderstood in our days?

The only right and legitimate way to such an experience is that it happens to you in reality, and it can only happen to you when you walk on a path which leads you to higher understanding. You might be led to that goal by an act of grace or through a personal and honest contact with friends, or through a higher education of the mind beyond the confines of mere rationalism. I see from your letter that Rowland H. has chosen the second way, which was, under the circumstances, obviously the best one.

I am strongly convinced that the evil principle prevailing in this world leads the unrecognized spiritual need into perdition, if it is not counteracted either by a real religious insight or by the protective wall of human community. An ordinary man, not protected by an action from above and isolated in society, cannot resist the power of evil, which is called very aptly the Devil. But the use of such words arouse(s) so many mistakes that one can only keep aloof from them as much as possible.

These are the reasons why I could not give a full and sufficient explanation to Rowland H., but (I) am risking it with you because I conclude from your very decent and honest letter that you have acquired a point of view about the misleading platitudes one usually hears about alcoholism.

Alcohol in Latin in spiritus, and you use the same word for the highest religious experience as well as for the most depraving poison. The helpful formula therefore is: spiritus contra spiritum.

Thanking you again for your kind letter, I remain yours sincerely, C.G. Jung.

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“* ‘As the hart panteth after the water brooks, so panteth my soul after thee, O God.’ Psalm 42,1”

Letter reprinted in ‘PASS IT ON’ The story of Bill Wilson and how the A.A. message reached the world, Alcoholics Anonymous World Service, Inc. 1984, pg. 383-385.

A rags to riches story

While making my way out the back door of the church on Easter Sunday, I picked up a discarded copy of PASS IT ON, the biography of Bill W., founder of Alcoholics Anonymous. A.A. holds regular meetings in the basement of my church.

There is so much in this book. Bill W. was a failure at high school, at university, at business, but he was possessed of such a keen mind that he became successful on Wall Street in the 1920s as one of the first stock pickers, a niche job that was almost unheard of until he came along. Of course, he lost all of that many times over through a craving for alcohol. Rock bottom for him was tested on many occasions. His doctor said he would either die or be confined to a mental institution for the rest of his life. But still, he kept drinking.

An acquaintance of his had gone to Switzerland to seek help from Carl Jung. After a year of therapy and a subsequent relapse, he went back to see Jung who told him he would never beat this until he had a “spiritual awakening.” Belief in God was not enough. He advised him to align himself with a religious movement.

Bill W. was not very religious, but he sensed that spirituality was a missing element in his life. It was some time after this that he had what is called a conversion experience. He cried out during a particularly dark moment “If there be a God, let Him show Himself!” The room suddenly set ablaze with a white light and Bill W. experienced the same kind of ecstasy that was known to Teresa of Avila, Saul on the road to Damascus and others. He was 39 years old.

The German psyche

What is it about German speaking psychiatrists? The pantheon of psychiatry’s superstars includes Freud, Jung, Fromm-Reichmann, to name but three. I also have found that those who have most influenced my perception of schizophrenia tend to be German speaking: Daniel Paul Schreber, Dietrich Klinghardt, Bert Hellinger, and Geerd Hamer. Of course, I am stereotyping, but I believe that German thinkers understand the complex underpinnings of self better than most of us.

I read an interview recently in the Financial Times with Simon Rattle, the principle conductor and artistic director of the Berlin Philharmonic Orchestra. Mr. Rattle is British, but has observed the German temperament closely in his tenure with the orchestra. The interview brims with his astute observations. “The (German) necessity of rules and strictness is a way of dealing with an enormously powerful impulse: Germans are among the most emotional people on the planet. Maybe it has to do with the fact that as a nation they are always drawn back to nature and the forest.” He believes that concept of German precision is a “self-imposed correction to the German psyche. Without it there would be complete chaos, because everyone is so emotional.”

Ergo, the German psyche is therefore well suited to understanding schizophrenia.

_________________________________
“Maestro Chef”, Interview with Sir Simon Rattle, Financial Times, June 20/June 21 2009

Family Constellation Therapy

In the final weeks of Chris’s attendance at the day program, I began in earnest to look for a psychiatrist who practiced Family Constellation Therapy. Given the special circumstances of our geographical location, it took a while to find that person. After a number of months, I found Dr. Maria Stern, a trilingual psychotherapist with a practice in our city.

Family Constellation Therapy and shamanic healing operate at level 4 of the healing pyramid. Dr. Dietrich Klinghardt speaks of level 4 as the intuitive level, the realm of dreams, trance, meditative states, out-of-body experiences, and the collective unconscious. Level 5, the peak of the healing pyramid, is the spiritual level, the realm of your personal relationship with a higher power, call it God, if you will. No shaman or doctor of priest can help you at level five. Healing at this level is up to you.

Family Constellation Therapy, also know as Systemic Family Therapy, was developed by German psychotherapist Bert Hellinger. It is based on the premise that all members of a family, living and dead, have the right to their place in the family tree. If someone is denied this right to belong through an untimely death, imprisonment, or perhaps being the family “black sheep” another family member will (usually unknowingly and often generations later) exclude him or herself as an act of atonement for the injustice.

Bert Hellinger writes that many of us unconsciously “take on” destructive familial patterns of guilt, pain, anxiety, depression, alcoholism, and even illness as a way of belonging or being loyal to our families. Bonded by a deep love, a child will often sacrifice his own best interests in a vain attempt to ease the suffering or solve the “unfinished business” of another family member. As Swiss psychiatrist Carl Jung famously observed, “Nothing has a stronger influence psychologically on their environment and especially on their children than the unlived life of the parent.”

According to Dr. Klinghardt, schizophrenia often has its roots at the fourth level of healing because schizophrenics are particularly sensitive to these familial exclusions or injustices and will act out the role of victim. Dr. Klinghardt maintains that if schizophrenia is not cured at the physical level (level 1), it is usually because the issues lie at level 4. According to the Family Constellation theory, the root of the issue is almost always found three or four generations removed from the present. The parents and current family environment aren’t directly responsible for the origins of the schizophrenia, but they are implicated because of the way the parent might unconsciously deal in the present with the aftermath of the family event from the past. I see this as yet another example of how an energy imbalance might be expressed within the family.

What is particularly compelling about Family Constellation Therapy is that it can put to rest so-called family curses or stop recurring patterns of illness or destructiveness from being passed from generation to generation.

The Akashic field and synchronicity

There are paranormal phenomenon related to schizophrenia, God, and physics. The Akashic field is an ancient Sanskrit term describing an ethereal library of all knowledge—thought, word, and action—that can be accessed through the subconscious mind. It houses the collection of universal truth, to which all people have access, and which all religions and shamanic traditions have acknowledged in some way. The Akashic field, also referred to as the universal mind or the word of God, shares much with Jung’s collective unconscious in which everyone participates through shared inheritance, thoughts and memories, which are symbolically manifested as fairy tales, myths and fantasies.

Conventional relativity theory says that the particles have to be close together to affect each other. The concept of nonlocality is a quantum physics concept that tweaks conventional relativity theory by demonstrating that you can accurately predict how one particle is behaving by how another is behaving, and that they have a causal relationship, even though they are separated by great distances. When Chris’s doctor does long-distance muscle testing on Chris, for example, she is tapping into the nonlocal library of knowledge to find the particular record that Chris has left in the collective unconscious, even though she and he are separated by a great distance.

Schizophrenia is a prime example of how the universal mind works, using another of Jung’s concepts, that of synchronicity. Synchronicity is the uncanny coincidence with which most of us are familiar. You were just thinking of someone you haven’t been in touch with for ten years, the phone rings, and it is that person on the other end of the line. One event does not cause the other. They occur because the universal mind contains both our consciousness and external events. Events reflect our conscious and vice versa because neither time nor place exists in the universal mind.

People with schizophrenia find meaningful coincidences or synchronicity everywhere. I remember heading to a Japanese restaurant with the family when Chris was sliding into psychosis. Chris was obviously impressed with the name of the restaurant, the letters of which were the first letter of each of his names, with a negation at the end. He was under the belief that the restaurant was negating or invalidating him in some way. He repeated the name of the restaurant throughout the evening, almost like a mantra.

That’s the funny thing about synchronicity. It is only meaningful to the person experiencing it. It is a non-event to others, and pretty boring to them as well. Yet when synchronicity applies to us, it is a different story. We are bemused perhaps, but not enthralled.

Believing in recovery

Many of us don’t believe in recovery. We think we do, but we are often unwilling to take the necessary steps. While I am admittedly hard on doctors, doctors can only get away with what they do because they have you as a patient. You may be of the scientific persuasion, a person who reassures him/herself with facts, double-blind studies, and the latest findings in leading scientific journals. You and your doctor will no doubt be very sympatico. When your doctor tells you there is no hope, you will believe him because it fits with the kind of person you are. You will continue to take your meds and be a good patient. You are most likely very conversant with what is written in the product literature.

The technical language of psychosis is so dreary it is hard to muster any hope. Prodromal symptoms, extrapyramidal symptoms – this vocabulary is how schizophrenia is introduced to new patients and their worried relatives. A big downer. When Chris was first hospitalized five years ago, the social worker told me brightly that why, in five to 10 years time, exciting changes were foreseen. I believe she was alluding to a miracle cure. The problem was, Chris didn’t have five to 10 years to wait for something that had eluded medical science for the past 100 years. He needed to start getting better immediately.

It is now over five years for Chris and I have yet to see that miracle cure, although I hear there is one underway. Nor do I expect one. It has taken me at least four years to realize that schizophrenia isn’t all about the biochemistry. Your doctor believes it’s all about getting the biochemistry right, though. In my experience, it’s not just the doctor prescribing medications who talks almost exclusively biochemistry, it may also be the doctor who is trained in alternative, complementary medicine. An MD after the name still makes doctors think mainly in terms of biochemistry.

Like Chris’s doctor who conceded initially that vitamins may not help, but they probably don’t hurt, this is how most medical doctors view the psycho/spiritual side of psychosis. They give it a place, but not a big one. Then they get right back to focusing on the biochemistry. The psychiatrists who specialize in certain therapies, such as Jungian, Freudian, Adlerian, Gestalt, etc. have a much broader perspective on the mind’s power to heal itself. These kinds of doctors are a luxury for many. We have also been told for the past several decades that “talk therapy” is of little help for schizophrenia.

If you are going to reach beyond a purely disease approach, become open minded to the rich tapestry of life, to writers, poets and people who think differently than your doctor does about the human condition.