Extreme States and the Power of Journeying with the Other


I recall working with a young man who had undergone sexual trauma at the age of 4. He lived in a chaotic family with an aggressive, addicted father. There was little positives spoken to this young man. He had an extensive history of psychiatric hospitalizations. What I began to note was that within the hospital setting he was able to ‘conform’ and was discharged in only a few weeks, but problems would erupt again once sent home leading to further hospitalizations. In one instance, this young man stayed in the home of those outside his family. Though there remained some challenges, he appeared calmer and more able to communicate.
I recall a similar instance with another child. The step-father was abusive both verbally and physically. The mother often because of her own fear would ‘cover’ for the step-father’s actions. The child in one on one settings never created any disturbance.
However, his behaviors in the home were often ‘disturbing’. I was pleased that during my work with him he was not hospitalized at any point nor on psychiatric drugs. However, I was aware that he had a prior history of this many times over. In both of these situations, I saw the family dynamics as oppressive and detrimental and tried my best to help the children navigate through the challenges with the system doing little to collaborate in meeting these children’s needs.
In light of these two situations, and hearing of others from colleagues, I determined that it was the home, the family dynamics that was the catalyst for making these children ‘mad’. When apart from these dynamics, they were able to conform to the rules of the institutions because they were forced to do so. But really what were the psychiatrists accomplishing for them? They merely subdued them with drugs, forced their compliance, and returned them to the same oppressive environment which led to their being hospitalized in the first place. It became evident that the psychiatric establishment could really care less, for each admission added to their coffers. The family was pleased to create a scapegoat rather than addressing the core problem and to have a place to send the ‘disturbed child’ to so that they could continue in their own self-interest.
I recall two other clients that I collaborated with in therapy. One was an adolescent boy who I will refer to as Alan. Alan was seen by most as an obstinate young man who had completely departed from any sense of reality. His hallucinations had earned him the diagnosis of a psychotic disorder not to mention he frequently displayed
aggressive behavior. Reading the charts from before, it painted a monstrosity, but gave little detail to what Alan’s experience might have been. When I first encountered Alan, I did not demand that he speak to me or that he not speak to me. I made no demands. I solely informed him that I was a supportive person who wanted to know him for who he is. This opened the door to intense dialogues. Together we explored questions about life that we both may have never thought much on before. The topics would drift to purpose, impermanence, suffering, the human condition. He related to me the pain of years of abuse, how he felt dehumanized and humiliated by the various people he thought would help him. He told me of his feelings of being alone, of being nothing. This feeling of nothing for him was an end at the time, but really it was the beginning. It was the door for him to question life, to question what he had been taught, to become. He related to me about his hallucinations, and his imaginary friends became mine as well. I asked about their habits, and their words. I noticed that these beings he saw were him at various points in time. As I met each of these beings, I learned something a bit more about the experience of Alan. Gradually as his emotional needs were met and he began to see himself once again as a singular person in the present moment of time and space, these beings began to depart. I saw in Alan the resilient human spirit and I will not forget him.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

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Dan Edmunds, EdD
Dr. Dan L. Edmunds is an existential psychoanalyst and psychotherapist in Northeastern Pennsylvania. His work has focused on drug free, relational approaches for those undergoing extreme states of mind as well as autism and developmental differences. Dr. Edmunds is the founder of the Center for Humane Psychiatry, an emancipatory movement for human rights in the mental health system. Dr. Edmunds has advocated for psycho-social approaches for those in distress that are affordable and accessible. Dr. Edmunds developed a therapeutic community project and is involved with autism acceptance and the autistic rights movement. Dr. Edmunds is the author of BEING AUTISTIC: AN APPROACH TOWARDS UNDERSTANDING AND ACCEPTANCE; THEY SAY MY CHILD HAS ADHD: DEBUNKING THE BIO-PSYCHIATRIC PARADIGM; THE MEETING OF TWO PERSONS; and MYSTICAL METAPHORS. Dr. Edmunds is a frequent speaker on critical psychology issues.


  1. Thanks Michael and Alix.
    Alix- I hope things are well for you now. Please do feel free to write me. I still struggle to understand many in my field today and the direction they take. People need others to just be with them, it seems simple to me, but obvioulsy not to others

    • Thanks Dan, It all happened a long time ago before psychiatrists started diagnosing and drugging emotionally disturbed Kids and youngsters. I realise now with hindsight that if only I had had a sensible grown-up to talk to and who would have been able to see behind the facade I was putting on, I would have not collapsed and started hearing voices in my head discussing me and putting me down. I relise also that the treatement young people get nowadays, would have only made things worse. All I needed was love and understanding and peace and quiet to recuperate physically. I got it all eventually but it was a hard struggle to get back on my feet. It takes time to heal.

  2. I worked in a school with a 13 Y/O boy who had a diagnosis of ADHD and who was on Ritalin. I was a teaching assistant and I was only with him for a few weeks. The deputy head gave him some stern words, saying he would be out of the school if his behaviour did not improve by the end of term. It didn’t, he was thrown out and I left for other reasons.

    I was with him for most of the school day. I found out that if the teacher knew how to relate to the class the class he was fine. If not and one of his friends played up he did too, only in a bigger and more disruptive way. It did not look like a disease needing drugging to me. It looked like insecurity and machismo and young middle class teachers who did not know how to relate to working class boys very well.

    I told the headmaster what I saw, he did not have much to say apart from the fact that because the school was low down in the league tables it did not attract the best staff and that it was the head of departments job to help the young teachers deal with behaviour issues.

    The staff had a meeting about him with his parents and other professionals. I was not invited despite being with him everyday and therefore perhaps knowing him better than any other staff member.

    I had no support, no supervision, no one helped me do my job. It was an authoritarian school so there was little opportunity to get to know the boy and understand him more. The little trust we had developed was insufficient in my view to say to him what I had noticed, and beside I felt the school wanted obedience (so the other children’s education was not disrupted – though what kind of education it is where these sort of problems are either ignored or stamped out? Not one I can condone, because the lessons they absorb are about callousness and obedience to what were often stupid authorities).

    I was not able to get his teachers together to discuss what I had noticed and to try and find some ways of dealing with the situation based on compassion and understanding instead of the mainly useless and crass, “Sanctions ladder,” (off to the seclusion unit for you my lad, and next time it’s a note home asking your parents to visit and no mistake).

    What you describe is how life should be, instead we live in a cruel and callous world which drives some of us mad. So far your writings have left me feeling sad at the difference between how I would like things to be and the reality of our lives.

    I grieve for the lack of caring and compassion in the world.