As we struggle to invent a humane approach to the extreme states that get called “psychosis” or “madness” or “schizophrenia,” it may be helpful to investigate some of the better approaches developed in the past.
While these approaches are not without their flaws, they are often surprisingly insightful. (It can also of course be depressing to notice how truths once more widely known were so easily “forgotten” as compassionate approaches got ditched in favor of the latest coercive innovations.)
One of the pioneers in actually listening to those in extreme states was Frieda Fromm-Reichmann. She advocated assuming that every communication from those in extreme states contains meaning, and for appreciating that there is an “ego,” however beleaguered, within even the seemingly “hopelessly deranged.” She believed that if therapists would persist in reaching out, while respecting the person and his or her struggle, then communication would gradually become clearer, and the person’s special perspectives and talents could emerge and flourish.
Fromm-Reichmann is perhaps best known as being the therapist for Joanne Greenberg, who wrote a fictionalized version of her story of psychosis and recovery in the novel “I Never Promised You a Rose Garden,” and whose story was also covered in Daniel Mackler’s documentary “Take These Broken Wings.”
One person who has extensively studied the work of Fromm-Reichmann and others like her is Ann-Louise Silver, MD. In the short clip below, taken from the “Broken Wings” documentary, she contrasts the kind of recovery that can come from psychodynamic therapy with what happens when people are offered what she calls the “scotch tape” approach of medication:
So how does this psychodynamic approach work, and what parts of Fromm-Reichmann’s approach could be helpful to us as we design alternatives for today’s world?
Ann will address that topic at an ISPS online meeting on Friday 2/13/15, at 3 PM EST. This meeting is free to ISPS members, with a donation of $5-$20 requested from others, though there is also an option to register without donating if that works better for you.
You can register at https://ispsonlinewithann-louisesilver.eventbrite.com
Ann will also be a keynote speaker at the ISPS International Conference in NYC March 18-22, 2015.
Ann was the first president of ISPS-US, an organization started by people who were mostly psychodynamic therapists. This organization has since broadened, as awareness increased about the need to collaborate with those who have lived experience, and as knowledge expanded about the effectiveness of other kinds of approaches, and of the need to have different approaches available for people who may respond better to something other than long term therapy.
It certainly isn’t too late to register for http://www.isps2015nyc.org/ where you can hear from leaders such as Mary Olson (of Open Dialogue), Aaron Beck and Tony Morrison (of CBT and CBT for psychosis), and of special importance, lots of people with both lived experience of psychosis and expertise in other areas, such as Ron Coleman, Pat Deegan, Noel Hunter, Sascha DuBrul, and Oryx Cohen among many others.
I will also have a presentation there, titled “Admitting Uncertainty about ‘Illness’ and ‘Reality’ is Essential for Dialogue.”
Of course, many of you aren’t going to be able to attend big conferences like this – which is why I hope to keep working with others in ISPS to make available online meetings, accessible to all, which give people a chance to hear from leaders in our field in a live format that includes interaction with the audience. Expect to hear more about these meetings on MIA, and/or you can always hear about what’s coming up by going to http://isps-us.org/blog/online-meetings/
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.