Tuesday, June 30, 2009

Social breakthrough

Keeping in mind that there can be multiple explanations for a single event, Chris's progress following our Family Constellation sessions with Dr. Stern in July 2006 went like this:

In November 2006, Chris entered into weekly psychotherapy with Dr. Stern. That same month, Emily, the daughter of my university roommate, stayed with us for a weekend. She and Chris went skiing for a day. “How was Chris?” I asked her. “Quiet,” she said. “He was very polite and considerate, but only spoke to me if I spoke to him first.”

In February Emily came back for another visit and some further skiing. “How was Chris?” I asked her, hoping that I knew what she would say. “Oh, just great. He talked with me the whole time. I didn’t need to prompt him. What a big change from November!”

The magic had happened. Chris could now converse with people he didn’t know or didn’t know well. Sometime between November and January, seemingly from one day to the next, he began acting “normal,” despite the fact that he was still on low doses of two antipsychotics and had been on them for thirty-six months and in a day program for twenty-two of those thirty-six months. His day program had ended six months earlier. He left the day program still very much into his shell and not able to establish eye contact with people.

Using holistic therapies, he achieved social breakthrough after seventeen months of vitamin supplements, eight months after the assemblage point shift, six months after Family Constellation Therapy and after three months of seeing Dr. Stern once a week.

He began phoning up friends he hadn’t seen for years to suggest that they get together. He wanted to be around people. This was huge. For Ian and me, it was like a stone had been lifted from us.

From February 2007 on, Chris continued to improve. Dr. Stern and Chris's holistic psychiatrist worked together over the next year to gradually eliminate his medications while continuing his weekly psychotherapy. His weight dropped as the medications were lowered. By March 2008, he was off all his medications. To illustrate the extreme caution that needs to be exercised when lowering medications, it took almost one whole year for Chris to come off 25 mg of clozapine. By June 2008 his weight was normal once again and he was able to exercise more.

Ian's and my mistake following this breakthrough was to begin to build up our expectations of Chris. We became impatient for his moving on with his life.

Monday, June 29, 2009

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

Friday, June 26, 2009

You wait for the magic to happen

When you finish a Family Constellation, according to Dr. Dietrich Klinghardt, you walk away from it, you do not analyze it, and you wait for the magic to happen.

The magic was still to come for Chris. That would happen several months later. In the meantime, I decided that our household needed to become more of an Asian household, in the sense of honoring our ancestors. Through my mother's cousin, I located an old photograph of my maternal grandmother and grandfather, the first time I had seen them together, and put it in a silver frame in a place of honor, along with other old black and white photos of various ancestors.

Our family vacation that summer continued the theme of honoring our relatives. We visited a number of battlefields and war cemeteries in France. At Vimy, I learned where I could write for Ian's grandfather's war record, and followed up on that when we got home. At Arras, in northern France, I bought a pot of artificial flowers wrapped in cellophane. We drove on into Belgium where we stopped in Adegem to seek out the grave of my father's cousin, who was killed at the age of 20 securing the supply route between Bruges and Antwerp after the D-Day landing. We left the flowers at the gravesite. Chris lingered at the grave, clearly moved by something.

We returned home tired and drained. The vacation was unfestive, but necessary in the larger scheme of things.

Thursday, June 25, 2009

Take this burden

Two days later we were back for our second Family Constellation, save for Alex who had suddenly discovered commitments he could not possibly break. All the pleading in the world got us nowhere. Alex is tough like that. Dr. Stern understood and reflected that it is a good way to be, to be tough. In reviewing the outcomes of the previous session, Ian and I agreed that we felt closer to the reality of our ancestors’ lives. Chris seemed to politely agree.

This time, it was my turn and I placed the outlines of the shoes on the floor without thinking too much about where to place them. My parents, my sisters, and my mother’s mother, father, and brother became shoes on the floor. Dr. Stern took up her position as interpreter of personal dramas. She started out slowly, but horror gradually pervaded her body as she recounted, from the point of view of my grandfather, his wife's premature death from scarlet fever transmitted by my mother, who was four years old at the time. Dr. Stern put her hands over her cheeks and shook her head in dismay while rocking slightly back and forth. The presence of my grandfather was also there in the room, in abject despair over the unfortunate turn of events in his life.

Ian and I cried harder into the tissues provided by Dr. Stern and wiped our eyes. We were caught up in the drama. Dr. Stern, also quite tearful, looked up at Chris from time to time to gauge his responses. Chris, once again, was keenly following the action without saying much. Taylor, slumped in his chair in the corner of the room, was out and out bored, verging on sullen.

As I looked at the patterns on the floor, my mind began to wander. I was acutely aware of the injustices my mother had experienced, beginning with her mother's death. This particular family injustice began earlier than that, however. My great grandmother died when my grandmother was very young, just as my grandmother left my mother prematurely.

I never knew my maternal grandfather, having met him once when I was about three years old and once more when I was in my early teens. His fourth wife was slightly younger than my mother. They lived many miles away, but the lack of communication was not due to the driving distance between us. My mother, who was not given to saying unkind things about people, did not speak much about him. Her mother's death left her estranged from my grandfather, who she felt blamed her for her mother's death.

Dr. Stern paused to observe sadly that there was a pervading sense of death and chill in the room. Perhaps there was. The atmosphere was changed. Dr. Stern caught something in Chris’s reaction that she felt was important. At the end of the session, she said she thought she had it, and she turned to Chris and said that he should no longer have to carry this burden. He could begin to live. We left that day, totally exhausted but rejoicing in the family members who had gone before and we forgave them and them us. Harmony was created where before there had been disharmony caused by death.

Tuesday, June 23, 2009

Putting yourself in someone else's shoes

Dr. Stern was a tall, elegant woman with upswept blond hair and precise, German-accented English. She appeared to be in her late forties. Because of our particular circumstances, she conducted the Family Constellation with only our family members present. Normally, other participants or "actors" stand in for your relatives and interact in a dramatic interpretation. Instead of "actors" standing in for the family members Dr. Stern improvised by drawing the outlines of shoes on papers to represent the individual family members (a left and right shoe per paper). Chris, Alex, Taylor, Ian and I sat in chairs in a corner of the large office, wondering what would happen next.

We began with Ian’s paternal grandfather’s story. Dr. Stern asked Ian to put the shoes of the grandfather, grandmother, Ian's father, his father's older brother who died before Ian's father was born, and his father's two sisters on the floor.She asked him to do it spontaneously and not to think too much where the shoes should be placed.

Dr. Stern then literally stood in the shoes of each of the individuals and spoke for them, letting her voice rise and fall, speaking angrily or softly, or clenching her hands if she felt so moved. She gave voice to each of them, based on her intuition from reading the paragraphs I had given her. She was Ian’s Scottish grandfather emigrating to a new land, only to be sent back to the old world to fight a trench war, then returning to a strange land as an invalid, a convalescent beginning a family life. His firstborn son, carried away by death. Ian and I wept openly for father and first born son, who we did not know in life but felt a bond to in the present. Taylor and Alex looked bored, occasionally exchanging suppressed smiles.

Every so often, Dr. Stern would glance sideways at Chris, to see how he followed the unfolding drama and to see what his reactions were. Chris was attentive and interested. After three long hours, we were all grateful to leave.

Preparing for the Family Constellation

For the Family Constellation I booked three three-hour appointments for the whole family, spanning a little over one week in July 2006, as Dr. Stern was leaving on vacation shortly after that. I had done all the groundwork by creating a family tree, starting with Chris, Alex, and Taylor and working back four generations on both sides of the family, up to and including Ian’s and my grandparents. I wrote a short paragraph for Dr. Stern on what I knew about the lives of each of our ancestors, focusing on the disappointments or tragedies of the individuals. Where I felt I did not have enough information, I asked other members of my family for help.

I had faith that Family Constellation Therapy was the missing link for which I had been searching. I truly felt that if magic was going to happen for Chris, then this therapy would make it happen. I took Dr. Klinghardt’s and others observations to heart, that schizophrenia was a manifestation of a magical belief system. This belief system may come in part from beliefs that have been passed from generation to generation within the family. This belief system could also be thought of as the family energy field. The traumas of the present generation merely reflect the beliefs of the previous generations. In the specific context of schizophrenia, it is thought that the person with schizophrenia is particularly susceptible to feeling an ancestral burden.

In Family Constellation Therapy it is helpful to know the broad picture of the members of the family tree going back four or five generations: who died young and/or tragically; who might have benefited at someone else’s expense; who stepped aside so that others could join the family (e.g. a previous husband or wife,) who went to prison; who was the black sheep, and so on. Include as family members all known miscarriages, stillbirths, abortions, and first wives or husbands. This is no time to be shy or to try to hide the truth. An experienced psychiatrist will sense if something in the constellation is hidden.

Ian's and my family tree included paternal uncles who died early, one two days after birth in 1903 or 1908 and one who died at the age of three in 1924. I was struck by the fact that my father’s brother was buried in the family plot along with his parents who died years later, but he was unnamed and one of the dates on his grave appeared to be wrong. According to the gravestone, he was either five years old or two days old when he died. We knew it to be two days, so one of the numbers on the gravestone was wrong or else just eroded over time. In Family Constellation terms, not naming a baby and having the wrong death date on the gravestone denies the baby his rightful place in the family memory. On Ian’s side of the family, Ian’s father was given the same name as an older brother who died, as if the older brother was replaced by the younger one. What impact, I wondered, would that have on the family energy field?

My father’s father died when my father was eight years old. Ian’s paternal grandfather fought in World War I and came home with injuries, later developing an alcoholism that left a mark on the family. Ian’s maternal grandparents were divorced, which precipitated a flood of divorces in the generations that followed.

My maternal grandmother died in 1923 when my mother was four. She was my grandfather’s second wife, so I included the first wife (who ceded her position to my grandmother by dying) in the tree as well.

The past impinging on the present is an observation that is not new (ask any writer), but to me, who never gave it much thought in the context of my own family, it was breaking new territory. Looked at from the perspective of the dashed plans and hopes of previous generations, the feeling of sadness was overwhelming.

Monday, June 22, 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.

Friday, June 19, 2009

The ties that bind

In search of a new doctor after Chris left the day program and while we continued to look for a psychotherapist, Ian and I approached our family doctor. We figured a general practitioner would be less inclined to make clinical judgments about Chris, would be more open to our desire to eliminate the medication, and would have less difficulty working with Chris's holistic psychiatrist to get him off the medications.

We naively hoped that our family doctor wouldn’t be scared off by the diagnosis of schizophrenia. Our family doctor, without having seen Chris since he became ill, was clearly uncomfortable with taking him on in this new context. We explained that we were working closely with a holistic psychiatrist who was advising on the supplements and that we needed a local doctor to see Chris regularly to observe for himself that Chris wasn’t cracking up and to lower the prescription meds based on the psychiatrist's recommendations. The united approach and a plan failed to convince our family doctor.

Locating a doctor shouldn’t be such a big deal (even Dr. Hoffer writes that a regular GP could handle this), but that’s the position in which people with a diagnosis of schizophrenia find themselves. Psychiatrists, not family doctors, write the prescriptions for the chemical straitjackets that bind the schizophrenic to the care of a psychiatrist. Most family doctors are reluctant to treat psychiatric patients because they have not received much training in mental illness.

One problem with getting off drugs is the drugs. The drugs are very powerful and lowering their dosage can have frightening and dangerous ramifications if not done properly. The only way to reduce the dosage is very slowly, with proper psychological, nutritional, and vitamin support. These days, information on how to get off psychiatric drugs can be found on the Internet, complete with virtual coaching. I consider clinical supervision essential for anyone planning to withdraw from drugs. Unfortunately, a lot of people are essentially clueless and/or reckless and will persist in dropping medication cold turkey, with predictable results. Psychiatric patients can be difficult customers.

Thursday, June 18, 2009

The unreasonable, emotional parent

In June 2006, twenty-two months after starting, Chris’s time in the day program was up. He had squeezed an extra four months out of it due to his poor clinical presentation, but now it was definitely at an end. Dr. 'L' arranged for Chris to check in with the doctors for his medication monitoring while we looked for someone else.

At our second to last appointment with Dr. 'L', I left the meeting spitting nails I was so angry. It seemed to me during the meeting that Dr. 'L' was again trying to drive a wedge between Ian, Chris, and me, in order to gain the upper hand concerning our (Ian and me) wanting to eliminate the medication. Dr. 'L' knew that Ian was the more “reasonable” parent, meaning Ian was more inclined than I to urge caution about where we were headed. Chris, as usual, took a limited part in the conversation, so I felt I was left twisting out there on my own once again. “Fine,” I screamed at Chris, while simultaneously jumping up and down on our walk home, “do nothing, stay ill, I’ve had it! I will not sit down with Dr. 'L' one more time! You can count on that!”

After a few days, it dawned on me that if I didn’t attend the final meeting, Dr. 'L' perhaps had a good shot at convincing Ian of the foolhardiness of our position. Dr. 'L' could then raise the medication. There was no bloody way this was going to happen, so I attended the final meeting and took the high road. I even said somewhat tenderly, “I will almost miss you, Dr. 'L',” which was perfectly true as far as it went. He understood. It wasn’t his fault, I suppose, that he was stuck in a paradigm belief that psychosis could be effectively managed by medications.

Wednesday, June 17, 2009

Science getting in the way of cure

The day program that Chris attended for two years denied the existence of all causes of psychosis, except in the case of street drugs. Periodically, someone connected with the local hospital or with the social services network would speak to the bi-weekly meeting of family and patients about the evils of pot and other recreational drugs. This enraged one of the mothers, who, barely holding back tears, objected to the constant focus on pot, which her daughter had never used.

Over the course of time that I attended these meetings, I began to feel that the interest of the wider medical/social welfare community in patients in the program verged on voyeurism and/or profiteering. It seemed like every two weeks a new “guest” was introduced at the meeting who was a researcher, or someone involved in drug prevention programs, or a visiting doctor from another treatment program. We were just lab rats, to be studied for someone else’s scientific interest. Where was the individual in all of this, to say nothing of the cure?

In the focus on cure, as opposed to science, little progress has been made by many. More than a hundred years ago, Daniel Paul Schreber, addressed his psychiatrist: “There would then be no need to cast any shadow upon your person and only the mild reproach would perhaps remain that you, like so many doctors, could not completely resist the temptation of using a patient in your care as an object for scientific experiments apart from the real purpose of cure, when by chance matters of the highest scientific interest arose.”
Daniel Paul Schreber, “Memoirs of My Nervous Illness,” New York Review Books Classics (January 31, 2000)

Tuesday, June 16, 2009

Fish stew and cravates

Chris made a pot of fish stew last night, which is noteworthy for many reasons. The stew was absolutely delicious. Chris went out and bought the ingredients, consulted a recipe book, and produced a glistening, mouth watering concoction of white fish, clams, and red and orange peppers in a reddish broth. His brother Alex heartily complimented him on the meal.

In the past, Chris's culinary skills were lacking. He didn't seem to care what he ate or how it looked. Remember the peas or carrots? He let me choose. Recently, he announced to me that he wants to take more care with how he does things and how he looks. It is possible that his sense of taste and color are reviving. I have been down this road many times since Chris's problems began. Small things make me excited. We have all experienced these small victories.

He is still wearing the same dull necktie that he bought when starting university. "I began to think something was seriously wrong with Chris," my husband said, "when he chose the dullest gray tie imaginable from a rack of real beauties." My husband is a tie person.

Chris is intellectually able but does not wish to, or is not able to, pursue academic studies at this time. I wonder if he is more an artist now than the promising academic he seemed to be in high school. I do not take his lack of academic ambition as a sign that he has suffered intellectual impairment. Instead, I see a young man with a lot of musical talent and untapped creativity.

Monday, June 15, 2009

A culture of low expectations

The other day I attended a lecture by a prominent psychiatrist. The topic was stigma surrounding the mentally ill. He had done an extensive study focused on people with schizophrenia. He found that often people with schizophrenia practice stigma against themselves and cited an interview he had with a schizophrenic man who believed that he could not work. "Where did he ever get this idea?" the psychiatrist asked, genuinely puzzled that the man operated under this belief system. I was impressed by this psychiatrist because it was the first time that I had ever heard a psychiatrist use the words "work" and "schizophrenia" in the same sentence. By "work", I am talking about a full-time paid job, not volunteer work. I hope he was thinking the same. However, that he was puzzled about why his research subject would hold this opinion was troubling.

It is no surprise to the rest of us where this man gets the idea he cannot work. It starts with the psychiatrist, who generally has a gloom and doom attitude surrounding what people with schizophrenia diagnosis are capable of doing. If you want to see a brief look of panic/unease register on your psychiatrist's face, try suggesting that you would like to get your driver's license. Then, we move on to well known organizations' and institutions' websites that describe schizophrenia as "the most serious of the mental health disorders". They talk about schizophrenia in terms of functionality, social housing options and quality of life, as if that's the highest standard one can aim for. They talk about schizophrenia as a disease of the brain. They rarely, if ever, mention full time jobs. They talk a lot about hope, but I think our man can read between the lines. He has gotten the message right.

Saturday, June 13, 2009

Reading between the lines for help

I must say I am beginning to get weary of reading between the lines when it comes to finding helpful therapies for schizophrenia. What I mean by this is that there are many potentially useful therapies out there for autism, dyslexia, attention deficit disorder, pervasive developmental disorder, depression, etc. Rarely does the word "schizophrenia" appear in the list of conditions treated. So, once again, I gotta make the link myself. It's not like these problems are really all that different, so why does schizophrenia perpetually fail to make the list?

Schizophrenia deserves better. I am pleased that there is now serious focus on autism , but let's also keep in mind that schizophrenia is more prevalent in the population, and has serious social and economic consequences. In many ways, schizophrenia and autism are not that different, so why this disparity of focus? Is it because schizophrenia happens to adults or is it because schizophrenia is still thought of as untreatable, or both? If you really pay attention, the child who goes on to develop schizophrenia as an adult shares at least some of the traits in one or more of these other conditions.

Chris is currently doing the Tomatis Method. He goes to the center at 9 a.m. to avoid the crush of children at the end of the school day. Tomatis is a method of auditory training incorporating the music of Mozart and Gregorian chants. I had to read between the lines to see if it could be useful for schizophrenia. Apparently, it can be. I understand that the one and only article written by Dr. Alfred Tomatis on his method's applicability to schizophrenia is in French and has not been translated for a wider audience. I will write more about the Tomatis Method later when I get a better feel for any observed benefits.

Thursday, June 11, 2009

Hearing voices

I remember vividly how the the subject of voices was handled the one and only time it was raised during the bi-weekly meeting with other patients and families. It arose because one young man suggested during the meeting that people learn to make friends with their voices, as he tried to do. A worried look flashed between the staff members present. “You must ignore them!” they exhorted. Other group members nodded in agreement, but they seemed uncomfortable, judging from the somewhat embarrassed silence that followed. The topic was dropped. After that, people like me knew better than to bring it up.

Now, this to me is ignoring the elephant in the room. For a whole slew of patients, medication doesn’t quell the voices or the visuals. Medication wasn’t effective at stopping Chris’s “fleetingly improvised men” and I often thought that the medication actually aggravated them. It sure didn’t tame them. The higher the medication, the more sedated you are, but voices and visuals can still persist. The program’s approach was to try to medicate the voices.

An alternative, more sensible theory about voices, first promulgated by Dutch psychiatrists Marius Romme and Sondra Escher, was that voices are indicative of something else going on with a schizophrenic that medication might be able to help in the short term, but couldn’t fix in the long run. The Hearing Voices movement founded in Manchester, England, in 1989, and Intervoice, an international online community, are two of several self-help groups based on Dr. Romme’s work. Members meet to share experiences and learn to recognize that the voices may be expressions of their own subconscious. The emphasis is on personal growth for each individual.

Dr. Marius Romme believes hearing voices is not an illness. The voices are messengers that speak about certain problems that occurred in the person’s life. If you try to kill the messenger by ignoring the voices or medicating them, you often make them worse, you fail to address the deep-seated problem, and the result is a chronic patient. The difference between patients hearing voices and non-patients hearing voices is their relationship with the voices. People who never become patients accept their voices and use them as advisers. In clinical settings, however, voices are almost always seen as evil messengers and are considered a sign of schizophrenia. This is bad news for the patient.

Wednesday, June 10, 2009

The glass half empty

Humoring Dr. 'L' was becoming increasingly difficult. We left the meeting with the understanding that the medication would be increased no more than 100 mg. Chris came home the following week with a prescription for an additional 200 mg. I e-mailed Dr. 'L' questioning this increase. He replied:

"I am surprised at your question, which indicates that I haven’t been clear enough, so excuse me. Chris suffers very handicapping auditory hallucinations as we have confirmed from our last meeting. In order to reduce this very painful psychotic symptomatology we propose to increase the medication by 200 mg. I thought that we were all in agreement with this strategy. That said, if as you say, the treatment is becoming the problem and not the solution, we should take this up at our next meeting. Chris can ask to reopen the issue of the medication with Dr. 'B'."

So, according to Dr. 'L', Chris still suffered from “very handicapping auditory hallucinations.” This was Dr. 'L'’s pessimistic view of schizophrenia. This very painful psychotic symptomatology “glass half-empty” vocabulary was a continuous downer. We only heard the bad news from Dr. 'L'. Bad news didn't help his patient's parents cope. What good did this kind of attitude do? And he still hadn’t fixed the problem. Ian and I believed that there was no way that raising the medication was going to fix anything.

Somehow we prevailed and the medication was raised only 100 mg. Dr. 'L' acknowledged that, at the end of the day, Chris’s loyalties would be to us and it was useless for him, Dr. 'L', to argue the point. Ian and I held the key to the drug cabinet after all. It had taken us two years to fully appreciate this point. I wished that Chris was able to be in charge of his treatment rather than be pushed around, but it was unrealistic. Chris was ill. In the acute stages, someone else had to make the decisions for him. In the later stages, the authority of his parents and his doctors overwhelmed him. He was torn and he was also medicated. In addition, he was understandably afraid that lowering the medication would bring his psychosis back. He didn’t have enough energy, intellectual or otherwise, to do his own research, to learn to rely on his own intuition, and to fight his way out.

Tuesday, June 9, 2009

Fleetingly improvised men

Despite the benefits that I had observed in Chris from the assemblage point shift, Chris continued to present a poor clinical image at his day program. In early June 2006 at our monthly meeting, I argued the never-ending medication point once again with Dr. 'L' in the presence of Ian and Chris. I was getting that “please, dear” look from Ian, but I persisted.

Suddenly, in the midst of our discussion, Dr. 'L' did exactly as I expected he would that day. He was determined to demonstrate to us why Chris’s medication needed to be raised. He focused his gaze on a point near the window where Chris’s gaze was wandering, and asked quietly and with evident dramatic flourish, “Chris, what do you see?”

“Uh, someone over there near the window.”

“Surprise, surprise,” I thought sarcastically. Chris was seeing people in the room who weren’t us. He was hallucinating. Instead of the term “hallucination” I like the term that Daniel Paul Schreber used to describe people populating the corners of his gaze. He called them “fleetingly improvised men.” To Schreber, these were "souls, temporarily given human shape by divine miracle".

Dr. 'L' had caught Chris in the act, and waved this around as proof positive that he needed to have his medication increased. I knew Dr 'L' would pull this trick and I was prepared, sort of. Chris had warned us before our meeting that Dr. 'L' wanted to raise the medication. I would have preferred to ignore Chris’s wandering eye, but it was rather obvious. So, instead, I said, “Yes, Dr. 'L', but in the bi-weekly meetings with the other families involved in the program, it has been said that we shouldn’t pay undue attention to voices. Therefore we haven’t. Of course he hears voices and sees things. Isn’t that what schizophrenia is all about? It’s not for academic interest that we talk about voices in the bi-weekly meetings in the first place. The drugs haven’t prevented the voices, have they, so what good are they in Chris’s case?” What I would have loved to add, but did not, was that two years in Dr 'L's day program hadn't fixed the voices either.

Alas, as I also predicted, we allowed Dr. 'L' to raise one of his two medications from 200 mg to 300 mg. Chris, after all, was acting more skittish than we had usually seen him in Dr. 'L's presence. It was hard to deny it, but the medications wouldn't fix it. We were stuck in this clinical program for better or worse and it was now a question of humoring Dr. 'L' until we could execute a graceful exit strategy from the program and the stupid medications.

Daniel Paul Schreber, “Memoirs of My Nervous Illness,” New York Review Books Classics (January 31, 2000)

Monday, June 8, 2009

Making a fool of the doctor and everyone else

Dr. 'L' had, on more than a few occasions, hinted that Chris was making a fool of him and everybody else. Was Dr 'L' going further by suggesting that Chris was acting? I had wondered the same thing. Yet it is difficult to reconcile that someone is acting with what seems to be a genuine inability to snap out of it. Could Chris “play” at being normal if he wanted to?

In his brilliant work The Divided Self, R. D. Laing recounts the thoughts of Joan, a recovered schizophrenic. Here, Joan addresses the word salad of supposedly meaningless things that schizophrenics say: “We schizophrenics say and do a lot of stuff that is unimportant, and then we mix important things in with all this to see if the doctor cares enough to see them and feel them.”

Laing observes, “A good deal of schizophrenia is simply nonsense, red-herring speech, prolonged filibustering to throw dangerous people off the scent, to create boredom and futility in others. The schizophrenic is often making a fool of himself and the doctor. He is playing at being mad to avoid at all costs the possibility of being held responsible for a single coherent idea or intention.”
R. D. Laing, The Divided Self (New York: Penguin, 1990), 164.

Friday, June 5, 2009

Poetry and play reading

Before and after our visit to the shaman, Chris attended a daily outpatient program for young people with mental health problems. He was an enigma to the staff. During our monthly meetings with his doctor, it was difficult to convince him to lower Chris’s medications because Chris’s “clinical” presentation was so poor. Chris was fairly happy and moderately talkative at home, but assumed the role of a mental patient at the program.

My exasperation sometimes spilled over. “Chris, can’t you just fake it for once?” I would complain. “Dr. 'L' holds the keys to the insane asylum. You need his blessing to get him off my back and agree to lower the medications. He is GO. You have to pass GO to collect the two hundred dollars. Get it?”

No, Chris didn’t get it. He appeared not to be able to fake his way out of whatever it was that was keeping him labeled “hopeless” at the program. Dr. 'L' told us in our next meeting that the staff were instructed to treat Chris especially gently. He obviously considered Chris a “nut case,” although he didn’t use that word. Instead, he said that he and the other doctors thought Chris was very bright, but they just didn’t know what the problem was. He pointed out that Chris had difficulty using scissors to cut paper during art therapy. “But, you know,” said Dr. 'L' earnestly, “we are amazed he is very good in acting class.”

I realized that I didn’t care any more what kind of clinical impression Chris gave. Maybe the clinic was the problem, I thought. True, it didn’t look good not to be able to cut paper, but then why was Chris able to do these things and more at home? He could quite dexterously handle tools to help fix things around the house. Maybe there was something wrong with having to perform for others at a clinic, to be judged by those around you, and to be compared to an apple when you are an orange, or maybe even a grape. Whatever the clinic was doing, it wasn’t doing it for me or for Chris. I had seen enough by then to realize that inside an institution was possibly the last place anyone would get well.

I had internalized some messages that now guided my thinking. Message number one (from Dr. Hoffer): Nobody who relies on drugs alone will ever get well. Message number two (from Dr. Klinghardt): The root of schizophrenia is often found at the fourth (intuitive) level of healing; if the problem doesn’t clear with therapies aimed at the first (physical) level, look to level four.

Dr. 'L' suggested that we read Waiting for Godot, as Chris reminded him of that play. It was easy enough to see why—the meaninglessness, indecisiveness, and inertness in the play mirrored Chris’s existence. Thereafter, for a brief period, Ian and I enlivened our lives, which had become confined to our couch, our television, and a nightly bottle of red wine, with a little play acting. We certainly appreciated where Dr. 'L' was coming from on this one. Ian assigned everybody roles. Taylor was Pozzo; Chris was Vladimir; Ian, Estragon; and I was the narrator. Chris read his part like a seasoned professional. He stepped outside of himself for once. His face took on an enthusiasm and a flourish. The play was the thing for him.

After spending several evenings on Waiting for Godot, we switched to poetry readings. Each of us read a favorite poem. Chris, in a clear and confident voice, with evident feeling and from memory, immediately volunteered this poem by Robert Frost:

Some say the world will end in fire,
Some say in ice.
From what I’ve tasted of desire
I hold with those who favor fire.
But if it had to perish twice,
I think I know enough of hate
To know that for destruction ice
Is also great
And would suffice.

(Fire and Ice by Robert Frost)

I recognize this poem as a very appealing to a schizophrenic sensibility. Fire/ice, love/hate. Ambivalence and death with a dollop of guilt thrown in.

We had informally approached Level 4 through our play reading and poetry. I saw the positive effect this had on Chris. More of this approach was needed to appeal to what was going on in his mind. We had done all we could at the base level of vitamins and electromagnetic interventions. We had yet to approach level 4 formally through therapy.

Thursday, June 4, 2009

Prince Charles and the Royal Family

Ten days later after our first visit with the shaman, Chris returned for a checkup. Although this second visit wasn’t strictly necessary, I was beginning to appreciate the journey as a way of preparing for the outcome. As expected, Chris’s assemblage point was whole and had remained where the shaman had repositioned it. Nonetheless, Chris got a top-up of diamond and carnelian on his chest only.

I decided that I would like to have my assemblage point put back into shape the old-fashioned way, using the shaman's blow and crystal wands. Given my age and the strain I had been under, my assemblage point had predictably traveled up the panic and anxiety line to the right side of my chest. The shaman's assistant asked me to stand with my back to him, tighten my sphincter, and hold my breath. Then he quickly thumped my right shoulder blade. I was caught off guard. Air was forced reflexively out of my lungs and I emitted a little squeak. So that was the famous shaman's blow! I then hopped onto the table where I was handed a giant quartz crystal wand that I struggled to keep upright over my assemblage point while the transducer pumped emerald crystal vibrations through my wine soaked liver. I stayed in that ludicrous position for twenty minutes.

A couple of days before, Prince Charles had delivered a keynote address at the World Health Organization about his belief that national health systems should take more account of alternative treatments such as homeopathy and acupuncture. I remarked on this to the shaman, who confided that established Harley Street doctors in London were quite concerned these days because members of the Royal Family were now largely seeing homeopathic doctors and other alternative medical practitioners.

I mentally began adding up the alternative treatments Chris had undergone: colonics; acupuncture; vitamins and supplements; energy medicine, including the magnetic mattress and a magnetic bracelet; Emotional Freedom Technique; and assemblage point shift. On a scale of 1 to 10, if Chris was a 10 when he was first hospitalized, then I would have to say he was now about a 5, a 4 at the most. He just was not visibly normal, meaning that he seemed somewhat nervous, was not comfortable around people in large or small groups and was not able to motivate himself. I attributed a lot of this to the effects of the medications, which I believed kept him in an anxious state, but I didn’t attribute all of it to the medications.

I felt that we were on the right track with all the interventions we had done up until that point, but that there was still a missing X factor that had not been addressed. The good that the vitamins had accomplished this far were undermined by the still heavy doses of meds. I believed that the benefits of the assemblage point shift would reveal themselves over the next few months and hopefully lead to a complete cure. We weren’t there yet. I still had not tried to approach Level 4 of the healing pyramid in a formal way.

As the shaman predicted, Chris gradually began to express his thoughts and convictions more. It was subtle, but it became increasingly apparent in the next few months. He more frequently expressed his preferences and sometimes lingered to talk a bit more. What surprised me is that I also felt that I was becoming more real. I became even more direct and focused.

Wednesday, June 3, 2009

The observer

An important concept in quantum physics is the role of the observer. There is a famous hypothesis called "Everett’s many worlds theory" that builds on Niels Bohr’s Copenhagen theory that an action seen by an observer has more than one possible outcome. Everett’s theory holds that the universe splits when that action is taken (or even when an action is not taken).

Physicist David Z. Albert has put a slightly different spin on Everett’s theory, which I believe is very important to the understanding of schizophrenia. Albert maintains that the term "many worlds" is actually incorrect and that a description that leads to a better understanding is to call it "many viewpoints." This is in essence the schizophrenic problem of ambivalence: holding two (or possibly) more opposing views in which the center cannot hold. It offers one explanation for Chris’s lifelong aversion to making a choice.

As a university undergraduate, I was an art history major, not a physics major. Physics is hard for me, as it is for most people, to wrap my mind around. The implications of quantum physics are still not well understood, even by quantum physicists. What I can say with some conviction is that an appreciation of schizophrenia will emerge in future from a further understanding of quantum physics and lead to new methodologies in treatment. For the compassionate observer, schizophrenia brings us closer to the knowledge that we are all subject to a supreme power in the universe, but a spark of that divinity is also within us.

To quote Hermann Hesse once more, modern science is in the Stone Age compared to the teachings of ancient Indian mythology. Ancient and indigenous peoples seem to have a better appreciation of multiple realities than modern people do. Indigenous people, such as the Toltec civilization from which Don Juan came, know that hallucinogens can deliver you to an altered dimension where extraordinary things can happen. Although he did not know the physics of the assemblage point, he knew what moving it could do.

It made perfect sense to me that Chris began experiencing altered realities or parallel universes at the time that his assemblage point was breaking up. The assemblage point is assembled in the womb in part by the vibrational energy of the outside universe. Altered states of awareness such as in schizophrenia and lucid dreaming may be indications that there are universes parallel to our own.

(See also "The Akashic field and synchronicity," April 22, 2009)

Tuesday, June 2, 2009

A parallel universe, even in the suburbs

The shaman and I continued to chat while Chris underwent his treatment. I learned all kinds of interesting things. Many of her clients and course trainees live in and around Amsterdam, where there is a high number of young people who have misaligned assemblage points due to drug use.

She has treated a number of epilepsy patients and cited one patient, a male in his late fifties, who had been an epileptic most of his life. He had many seizures during a typical day and, each time, his assemblage point would be jerked out of its central position and drop into the stomach area. He needed many treatments to his assemblage point before it gradually settled. With no change to his medication, he has been free from seizures for two years and was able to drive again.

We chatted further about the healing properties of stones and then Chris's treatment was finished and it was time to go. "What changes can we expect in the next few weeks?" I asked.

"You may begin to notice that Chris becomes more emotionally expressive," she suggested. "You may begin to notice that he walks taller and has a better complexion."

Her last remark was immediately prophetic. As Chris walked along the garden path back to the car, he walked in a way I hadn’t seem him do for years. Taller and with confidence. His face, which was always rather pale and yet much improved with the niacinamide, began to flood with color. I was amazed.

Back at home, I got to thinking about assemblage points splitting around the age of ten. I recalled a recent spooky experience of finding Chris alone and hallucinating in our darkened apartment and I began to reflect on an incident that happened to Chris in the park ten years earlier, when he was eleven. I was at home on a Saturday morning when Chris came running in from the park, clearly panicked. He hardly ever ran, so this itself was unusual. He locked all the doors on the ground floor of the house and pulled all the shades shut. He kept peering out, as if someone was coming to get him. I asked him what was the matter and he replied "some bullies are after me." I chalked it up at the time to just one of those things that happens to children his age, and let it go at that.

Now, something about Chris being in a darkened apartment and looking spooked, prompted me to ask him about the park incident all those years ago.

Signs of schizophrenia back then? I hadn’t recognized them. Was it significant that it might have started that long ago? Now when I questioned Chris about what had happened in the park with the "bullies" all those years ago, he finally leveled with me.

"Mom, I don’t want to say much about it except that I saw a spaceship land in the park and I saw extraterrestrials get out and they were chasing me!"

The prophet Ezekiel had a similar experience to what we could refer to as an extraterrestrial encounter. He described it instead as "the word of the Lord" coming directly into him. He saw a whirlwind and fire, and four creatures with wings and a wheeled vehicle thundering down from the sky. "The appearance of the wheels and their work was like unto the colour of a beryl: and they four had one likeness: and their appearance and their work was as it were a wheel in the middle of a wheel . . . This was the appearance of the likeness of the glory of the LORD. And when I saw it, I fell upon my face, and I heard a voice of one that spake."

I could worry about Chris’s revelation, or I could deconstruct my fear, as was beginning to become a habit with me. Did it mean he was sicker than I imagined since this had been going on so long? So he had signs of schizophrenia when he was eleven. It would be odd to think that schizophrenia just pops up all of a sudden at seventeen or eighteen. Did it mean he couldn’t get well? I doubted it. Maybe a more reassuring explanation is that he had experienced God.

Quantum physicists have another explanation, one which I believe is complementary to the knowledge of the existence of God. They believe that extraterrestrial experiences are hallucinations, or altered states of awareness that are "parallel universes" to our everyday reality. Parallel universes are almost identical to our own but weirdly different in some way, like the comic book planet of Bizarro World. Science fiction writers have relied on this quirky theme for years. Peter K. Chadwick, in a paper delivered to the Scientific and Medical Network, stated that schizophrenia might be understood if you considered that "genuine spiritual and paranormal forces operate on the person at least during and perhaps before and after their schizophrenic illness and that the realization and acceptance of this should form an important part of the treatment and rehabilitation process for such patients." What many people call "paranormal," a quantum physicist might say is simply the limits of the current knowledge of the universe.

Peter K. Chadwick, “Is there an ‘X Factor’ in Schizophrenic Illness?” http://www.scimednet.org/Articles/MHchadwick.htm