When the Hunger for Real Knowledge is Enough, Change Will Come


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.


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  1. Hi Carina, Thanks so much for sharing this. It’s one of the shorter articles to be found on Mad in America, but all the stronger for that because of the simplicity and essential nature of its message. 🙂 It’s a nice way to start out a Monday morning to the new work week after a somewhat difficult last week. It was good to see you in the States, and I hope to see you again soon! 🙂 – Sera

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  2. hi, carina. i so loved your article because it gave me hope. as one whose husband was trapped in the legal drug nightmare and and had so much destroyed for my kids and me i fight back any way i can. the truths are crystal clear to me and i often have taht feeling of talking to brick wall after brick wall. but your article and your message about the hunger for knowlege are just what i needed to read today.

    thanks you so much for your important work and important writings.


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  3. Could the something else that happens be the addition to your marvelous approach be non coercive of course ,Traditional Naturopathy , Homeopathy , Wholistic Dentistry,Bach Flower Remedies, Energy healing systems like YuenMethod, Green organic vegetable juicing , Oral niacin and mineral baths , Herbal formula’s, Body work, Tai Chi, Yoga, GMO free foods, and other stuff mentioned at Monica’s site http://www.BeyondMeds.com ?

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  4. “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.'”

    Wow, it’s incredibly disturbing to hear how hard people try to stop hope, truth, light, and healing from infiltrating mass consciousness. That cannot be good Karma. Kudos to those, from wherever they come, who break through those barriers and traverse new ground as pioneers. That is courage personified, and hope for all.

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    • Hi Alex, That is the central issue with the message as it struck me, too. Plus, what a process resolving the hurtfulness and the psychic pain of encountering it. We need healing powers just to bear up in comprehending someone else’s getting demeaned, debased, abused, no matter that the final course they put their lives on was as good as Elgard’s was. Talk to you–

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      • Yes, that is a very particular healing process. It affected me adversely for a long time. I learned to perceive these experiences from a broad non-personal perspective, however, and it informed my path, purpose, and sense of self. That’s how I healed it entirely. Didn’t kill me (by miracle) so it made me a helluva lot stronger, wiser, and extremely empathic to oppressed people. Have you read John Howard Griffin’s classic, Black Like Me? I get it now. Tough road, but oh-so- enlightening. Gets easier, though. Time heals all wounds, if we don’t keep scratching at the scabs.

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        • I should reread that classic little book sometime. In some ways, it fits on the same shelf as Eric Hoffer, who gets quoted in the types of current affiars commentary I like. (Know of him?) Anyway, your process for encountering the suffering and misery of others goes beyond mine, as it stands. I have to labor in general to adjust in fits and starts, but understand my goal is transcendence and also equanimity, you could say. You can’t help but achieve some measure of transcendence if you so much as try, it seems, but calm, cool, and collected, and ready to sacrifice for others takes the kind of understanding that leaves no different options in view. Not to imply single-mindedness and intense determination too much, rather like Barbro Sandin in Sweden having pure loving conern keep her focussed. One of the reasons careers in the helping professions never appealed to me was that the likelihood of making up for people who tried to hurt someone like her would never end. My attention on complementing the efforts of anyone like her in my own manner would have competed non-stop with trying to fight the powers that be so that I would not be such good hands-on as a carer anymore. I also wouldn’t have wanted to manage (administrate over) most of the people I saw going into the fields in my younger days. Now the most noticeable thing is the scant interest shown in helping survivors of their official and business as usual styles of interaction recover their immediate or losses or more profoundly degraded human potential.

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        • Sorry for the grammar mess.
          Barbro Sandin’s pure loving concern’s keeping her focussed…
          the likelihood of making that injustic against her kind of person come to an end was nil (for me, in the American scene)…
          help survivors to recover their more immediate losses (instead of reminding them how dysfunctional they are and to keep patient)…

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  5. Love the article Carina.

    Couldn’t help but smile when I was reminded of Knut Hamsuns novel “Hunger”. Is the starvation for knowledge leading us into a delusional state regarding the treatment of those deemed mentally ill? It would seem so at times.


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    • “Is the starvation for knowledge leading us into a delusional state regarding the treatment of those deemed mentally ill?”

      Absolutely brilliant, boans. And a resounding YES from me! That is truth.

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  6. I am working on how to find the reserach reports, designed by Rolf Sjöström and Johan Cullberg ( two different studies though).
    The Cullberg report shows that most of the people Barbro worked together with “recovered”, which led traditional psychiatrists to claim “the patients were not really schizophrenic”.
    This very weak argument is unfortunately often used by those who by some reason dont welcome when people get well. I often wish that some of the doctors who have claimed about “my clients” that they will not make it without medication would admit they were wrong. It has never happened!!! Anyway, I realize that I feel more rage the last years, and less patient – still having a hope and intention to continue the work we do. Actually, there is no other way.

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  7. Carinna – Everyone has got to decide for themselves how to extend care, treatment, and respect others, and also has to know what attitude and responses seem most natural and appropriate for how others, in turn, treat them. Unfortunately, the institutional standards of care in mental health these days usually support the idea of meddling in the good work of clever, humane innovators and obstructing the efforts of anyone who wants broader accountability and greater respect for all. The freedom to choose just introduces too many variables for the rent-seeking users in charge of the operating principles of the current, scandalous paradigm. Meanwhile, many more wait their turn to earn reputations for intelligent participation in the efforts to provide “care for the mentally ill”, and they find themselves under recruitment from this same water-logged system. Your words are so touching and make the need for change feel so immediate! I hope you can see more signs of reason to believe in tomorrows with a human psychiatry, intead of this brutal machine of forced treatment that causes so much harm now.

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  8. I really like the way you described what she saw as core: creating a safe place. A trusting relationship to review how we see things, what we have experienced and what sense me make of that. Just creating a trusting relatsionship.

    Isn’t that what we all need?

    I have found nothing else works and indeed it is thing I can offer to anyone who is distresed.

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    • Hi John, yes, a safe space is for sure what we need all of us. The “weird” thing though is that by some reason it does not seem to exist so much in the psychiatric system where human beings are met by a manual based formula during the first meeting, or given a diagnosis based on, as I think far too fast assumptions about the person whom it concerns.

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      • The other thing that happens is that people get refered to therapy, usually breif, say 10 – 20 weeks of therapy and they get an assessment interview. They are expected to spill thier guts to someone they will never meet again and then wait for about six months before seeing anyone.

        That in itself is a grueling process to go through that is probably of no help to most people and damaging to many.

        It is however something that marketised packages of, “Care,” seem to demand

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        • Thanks for the reminder, John. You pay lots of attention to our issues. Likewise with the pressure to give up the tapes in one heave, just getting started with your therapist and then finding yourself redirected within the same group, when it shows that they knew the shifts were going to hapoen and skipped informing you, is some wrench in the gears.

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