Back to Schizophrenia 4

I had moved away from this topic and on to some other research and writing, but then I watched a film about R.D. Laing, ” Mad to Be Normal”, about the time period from 1965-1970, when Laing operated Kingsley House in London, and it drew me right back into the alternative programs of treatment for people with schizophrenia.

I returned to a few of Laing’s books and Joe Berke’s “I Haven’t Had to Go Mad Here” (1979), as well as John Weir Perry’s “The Far Side of Madness”(1974). Laing, Berke, and Perry subscribed to the view that societal reaction to individuals with psychotic symptoms (or even other emotional/interpersonal disturbances) has typically been to employ various means of control and treatments to transform or even obliterate (electric shock, tranquilizers, etc.) troublesome symptoms. They ask, “troublesome to whom?” According to Laing, Berke, and Perry, it has been “troublesome” to family members, friends, work mates, and the psychiatric profession has been enlisted to “normalize” behavior – sometimes by whatever means possible. In addition, I listened to the recording of my 1993 interview with Joe Berke, which I mentioned in an earlier post about Berke’s book with Mary Barnes, ” Two Accounts of a Journey Through Madness”.

My interest here is in the epistemology of what is considered “mental illness” and how a particular cultural and institutional construction determines approaches to treatments and aspects of marginalization. From Foucault’s notion of discipline and punish (with particular reference to prisons and mental institutions) to Mary Douglas’s ( in her “Purity and Danger”) notion of things out of order being perceived as polluting, people with schizophrenia have historically been warehoused, heavily medicated, and/or otherwise marginalized from any mainstream society. Laing, Berke, and Perry, as well as the relational psychotherapists, Harry Stack Sullivan, Otto Will, and Frieda Fromm-Reichman, approached people with schizophrenia as regular human beings with different behavioral challenges, for whom the need to be able to have genuine communication with others is essential to their healing prognosis. Though Laing’s Kingley Hall and Berke’s Arbours Centre did not use medications, except when a resident was a danger to themselves or others, the development of several anti-psychotic drugs in recent years, has provided options of combination treatments – as explained in my earlier posts. Nevertheless, the temptation to medicate and not provide appropriate psychotherapy for people who have schizophrenia continues to be a significant weakness of contemporary psychiatry.

When I visited one of the Arbours Centre residences in 1993 and talked with several of the guests (residents with schizophrenia), I learned that they had dramatic stories of the contrast between their previous institutional experiences and the structure/non-structure and atmosphere of an Arbours House. The guests experienced what they called a “drug holiday” while at Arbours. They experienced respect. They experienced a balance between structure and freedom. They experienced supportive companionship. They experienced empathic healers who treated them as human beings who had needs for attachment, love, and communication with others.