Every day I get emailed by people from all over the planet telling me how negatively the mental health system has impacted their lives or the lives of their families. I also hear regularly from therapists, and occasionally psychiatrists, about how they were trained in ways that they have come to realize are not helpful or are directly harmful to their clients. These people find me through my writings or my films. I find it exciting to connect with so many people, yet at the same time I find it scary, even depressing, to realize just how pervasive are so many of the biological ideas of traditional psychiatry.
Psychiatry’s backward point of view has been so effectively popularized that few intelligent people, unless they or those close to them have been directly harmed by its system, even question it. I’ve had many smart, educated acquaintances who are flummoxed, for instance, when I tell them that I make films about recovery from that thing called schizophrenia without psychiatric medication. Most have never heard of this concept, and they see me as some sort of odd creature — like a bizarre conspiracy theorist…or maybe a Scientologist. They usually get more respectful when I explain why I came to my point of view.
My experience has shown me that healing from these extreme mental states that get labeled as schizophrenia and bipolar and schizoaffective disorder is not so uncommon. In fact, it’s pretty normal to heal from them — and would be a lot more normal if we as a culture and a mental health system didn’t get in people’s way so much with our supposedly cutting-edge medical treatments. As a therapist in New York City, I saw it myself. I saw it less with people who had bought into or had been forced into the medication-and-hospitalization attitude of psychiatry — they recovered less, if at all. I saw it more with people who were rebellious — and who wanted to heal the way that their hearts told them to heal. They did it many different ways. Many clearly expressed that what psychiatry labeled as psychosis was for them in actuality a yearning to heal, a hunger or even desperation to access split-off parts of themselves. Few described it as a painless process, because it often came at great cost, but many found value in it — especially when those around them respected their process, saw meaning in what they were going through, and even tried to assist them in going through it. Simply drugging the upwelling feelings and thoughts to make the person seem normal and calm was generally the dead wrong way to deal with it. That killed the meaning.
In recent years, since becoming a filmmaker on the subject, I have met many more people who have gone through the extreme states that garner the extreme psychiatric labels. Many did their healing without any therapy at all. Some nurtured themselves through eating healthier, some exercised more, some sought out others who had gone through similar things to what they’d been through and found support through them, some have moved out of the city and into nature, some journaled intensively, some have tried herbal supplements. Others strove to learn how to sleep better, because they felt (often correctly) that their extreme states were precipitated by poor sleep. Some delved into their painful childhood issues and felt that getting a grip on this, through excavating their personal history and also family history — and grieving their past horrors — really brought them an inner depth, awareness, and peace unlike any they’d previously known. And some moved forward in other ways: by seeking out friendship, different jobs, better housing, a return to school. And some sought my help to resolve longstanding conflicts in their family relationships — with their parents, siblings, boyfriends, girlfriends.
“But,” my critics have said, “you clearly haven’t met anyone who was deeply in a schizophrenic episode. You could talk with a really psychotic person all you want and give them a nice, supported life and it doesn’t help. They need medication. What you’re saying is dangerous.”
My reply: In my first film, “Take These Broken Wings,” I purposefully focused on the story of two people diagnosed with severe schizophrenia who came fully through their psychosis without antipsychotics — and with therapy — and haven’t gone back into a crisis in decades. I chose them because they represented the supposedly impossible, incurable cases. And they’re not that uncommon. I could give countless examples of people like them.
But in some ways I agree with the criticism. Often talk therapy alone, especially once or twice a week one-on-one, is simply not enough. That’s why I made my films “Healing Homes” and “Open Dialogue.” “Healing Homes” is about the Family Care Foundation, a Swedish organization that places many people who would otherwise be in mental institutions in farm families in the countryside. In these farm families they have a chance to heal in a much more intensive environment than anything that once or twice a week therapy alone could provide. It does help that the folks who come to the Family Care Foundation do also get therapy — as an adjunct to the more important treatment: healthy family living. The family living, which might last a year or two or more, represents a radical lifestyle shift. And in the exact opposite direction from traditional psychiatry.
And “Open Dialogue”: this film is about a psychiatric program in Western Lapland in Finland that gets the best documented, statistical results in the world for the treatment of psychosis. Their work has been scientifically followed for more than 25 years, and their methods, though psychiatric, basically turn conventional psychiatry on its head. Although some people in their system experiencing psychosis do get hospitalized and treated with drugs, a far majority do not. Instead, they aim to keep people out of the hospital and off antipsychotics and instead provide them and their families with intensive, often daily, family therapy starting right at the beginning of their crises. No long waiting times — times in which people’s problems only become more embedded and intractable — and no cost, either, because it’s all a free part of Finnish socialized medicine.
“But so expensive!” people argue. “The Finns are rich! They can afford that. We can’t!”
Not so. First, Western Lapland is poor by Finnish standards. And what’s most special is that Western Lapland spends less per capita on psychosis than any other part of Finland. And the reason is quite simple: if you help people sort out their internal and interpersonal process, and help them do it quickly, they don’t become long-term consumers of the psychiatric system. They and their families make sense of their lives and move on, leaving psychiatry behind. The real expense in the mental health system is not Western Lapland’s super-intensive Open Dialogue family therapy with two or three therapists (who often travel to people’s homes and see them there, because people like that more and feel more comfortable there). The real expense is long-term, repeated hospitalization, long-term drugging (with brand-named drugs), and most especially the long (though drug foreshortened) lives of people who become disabled for life and more often than not don’t work. And that’s just the financial cost. What of the human cost?
The emails I receive every day attest to that. This, I admit, weighs heavily on me. So often they are from people whose lives have been wracked with suffering. They are confused about what to do, because often they are provided no good options — and no hope. These better options are out there and they’re not that complicated. They just require more emotional, human investment from the helpers, more openness from society, more of a return to real science in their search for best-evidence practice, and less of a push to drug away people’s pain and confusion and frustration. This requires a paradigm shift.
Yet I also get emails from people who are working through their issues and are healing their pain and healing from their painful histories. I get emails all the time from people who were labeled with schizophrenia and other unpleasant-sounding things who no longer carry these labels: they left them behind. They left the mentality of the mental health system behind. They left their drugs behind. These people are everywhere. Most don’t announce it publicly because it’s so shameful — they get stigmatized or even put back in the hospital against their will if they speak out. Many of these people don’t realize how common they actually are, because they may have never spoken with others who have gone through similar things, and certainly haven’t come into contact with them through the mainstream media. But they are everywhere. Several times I have even randomly sat next to such a person on an airplane, and only found out after I told them what I do for work.
So do I have hope?
I wish I could say yes with an absolute confidence. I do not have this. The traditional mental health system, in my opinion, is largely sick and in denial — and very powerful. Many practitioners are beautiful people, but their work environments are so stuck, their professional expectations so warped, their training so bad, and the science upon which their training is based so flawed that the tide of poor care in which they participate is ultra-powerful. Yet…hope abounds…in the cracks in between. Good, small programs exist in countries with generally rotten mental health systems. People recover all the time without getting caught by the hooks of traditional psychiatry. And more and more people are sharing their stories of healing — publicly.
And slowly the movement to change things is gaining traction. Slowly…the information is spreading. Slowly…the dialogue is expanding. Slowly…but it is happening.