I have recently returned home to Sweden after a great visit in the U.S., where I met some brave, encouraging, bright and warm people. Amongst other things, this has reminded me of my mentor Barbro Sandin, a Swedish psychotherapist who in the early 1980s created a kind of revolution in the psychiatric system when she claimed there is no such thing as “schizophrenia” as an illness. Rather, she said, people are having reactions to a life that is too hard to deal with.
Barbro did her internship to become a social worker at the Mental Hospital in Säter pretty late, when she was 45 years old, and had so far not been in touch with “professional care.” She use to tell me how shocked she felt when meeting young people walking around like zombies on the ward, heavily drugged. There were three standard questions asked at the daily round; “Have you slept? Have you been eating? Do you have hallucinations?”
When she asked her colleagues how come people were treated like that, she got the answer, “they suffer from a chronic illness called schizophrenia and there is no cure.” However, this was hard for Barbro to believe and so when a young person – his name is Elgard – seemed to notice she was at the ward, she suggested to him that they take a walk in the big park. They went for a short walk in the park; so far no words, just a walk. This turned out to happen every day, and after some weeks Barbro was told to see her manager who told her she was no longer allowed to take a walk with Elgard.
“How come,” she asked.
“Because he might get worse from your walks,” he answered.
Barbro use to tell me how happy it made her to hear this since, as she says, she then realized that if he can get worse, he can also get better. From that day Elgard met with Barbro for some hours a week at her office, and slowly a conversation was taken place, step by step. Their shared work had huge consequence for both of them; Elgard left the hospital after seven years and never went back. He wrote a book and became a psychologist himself, dedicated to the mission of meeting people in a humanistic way.
Barbro realized what she had to do; to try together with others to make a change in the psychiatric system. She became a psychotherapist, doctor and educator and challenged the current system in such a way that powerful men and women tried to stop her; accusing her of terrible things, threatening her children, and above all claiming that the way she worked would never be able to copied, despite the fact that research showed stunning “results.”
Barbro was influenced by Frieda Fromm-Reichmann and D.W. Winnicott, and their therapeutic work built on the importance of creating a safe place, where a relationship might be created wherein to make sense of what is happening in the mind and what has happened in life. She was also influenced by R.D. Laing who showed in practice something else has to be done than what was done within the dominant medical approach.
Every talk I was involved in during my stay in the US included these central issues: How to create a safe space so that people may find a way to make sense? How to build organizations where relationships might be created?
These questions are also constantly present in my work life, here in Sweden. I am fortune to be part of an organization which many years ago I decided to take a stand, and to create something outside the box. But the dominant system is affecting and influencing it in ways that are not possible to get away from. There are days when it feels as if nothing has happened since the beginning of the 1980s, when Barbro entered the ward at Säter´s Hospital. Sometimes it actually feels as if it is even worse
Manualized formulas, different psychological approaches, a huge number of methods and models going by a variety of letter combinations have become the way to meet people in life crisis. It does not seem like a very good solution; rather the opposite. There are more psychiatric diagnoses than ever, the prescriptions of drugs are more frequent than ever, and kids are diagnosed and drugged in ways we have never experienced before.
So what is the hope? How come we still do the things we do, or at least – try to? When talking with Barbro about these issues today she said that her mentor, the Swedish philosopher Alf Ahlberg, used to say, “human beings will survive, and so when the hunger for real knowledge is big enough a change will come”.
I intend to hold on to that, and when meeting people in a variety of different contexts, reading posts from people all over the world at MIA, being part of arranging our film festival, reminding me of pioneers who created a possibility for those of us who came after them to follow, I feel fine. Actually it feels as if something else will happen. Not without efforts and not without doubts and times of fear. But it will happen.
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.