It is an absolute privilege to write a blog post for Mad in America. I had contacted Robert Whitaker asking if he might read a new book of mine that will be coming out from Belly Song Press this fall, called While Psychiatry Slept. To my great pleasure he agreed to do so, but he also asked if I might write here to tell about my vision for the book and also about my friendship with John Weir Perry, one of the early and brave pioneers in treating first episode psychosis without medications in both hospital and milieu environments.
By way of introduction, I have been a psychiatrist working in both private practice and community mental health throughout my 35-year career. I received extra training in Jungian analysis, though not an analyst myself, and also in Process Oriented Psychology as developed by Arnold Mindell, PhD. I am currently the medical director of a community mental health center in Vancouver, WA and maintain a small analytically oriented private practice.
Sadly, during this time, I have watched the field of both psychiatry and psychology move further away in their theoretical stances from “the centrality of dreams, the importance of body, the necessity of story and imagination” and, especially, away from more creative ways of dealing with extreme and altered states of consciousness than the biological.
The Mad in America blogs draw out writings from many people, all questioning, at some level, how psychiatry could have fallen asleep to alternative views on psychosis, medication, side effects, therapy, commitment laws and other crucial topics. My goal in penning While Psychiatry Slept was to point out, with tongue in cheek, how in its somnambulism, psychiatry has forgotten that dreams were once the ‘royal road.’
We now know that the ‘dreaming,’ as the Australian aboriginals have called it, is occurring all the time, and arises in the conduits of the soul’s choosing: dreams of the night, symptoms in the body, the waking dreams of psychosis in hallucinations and delusions, relationship issues and synchronicities with the environment.
You might ask here as a reader, “But why are dreams so crucial to psychiatry?” I would tell you that they are the forgotten language of the psyche. They are the native tongue of the middle world, and this dialect is composed of metaphor and symbol, simile and synecdoche. All who enter the world of non-consensus reality, or what psychiatry calls psychosis, long for a physician with a therapeutic ear, trained to hear the patois of image. For as Jung emphatically stated, “Image is psyche!” It is only from here that we, as therapists, can track the deepest longings and movements of our client’s psychic reality.
I would like to explore, in a series of articles in coming months, how I believe returning dreams to their once central position in psychiatric theory can revitalize a field whose defining ideas have become completely materialistic in imagination.
I thought a good place to start this exploration of the dream-world would be with a section from the book’s introduction on the etymology of the word mad. When I was in the midst of writing my book, I struggled mightily with a case of writer’s block. It was then I had this dream:
Dr. Jung was with me while in his later years, moving slowly yet clearly still quite vibrant. Jung and I began to speak about what the problem had been with my writing and what was holding me back. I talked about my work hours, but said that these had improved and were no longer an issue. I told him that I was sure it was my ongoing struggle with being disciplined, but to my surprise he did not agree. He suddenly turned and faced me and with an impish grin said, “You must write from your madness, as I did.” He seemed to do a little jig and then added, “How do you think I wrote so many books?”
What does Jung mean that he wrote from his madness and what does it mean to write from mine? Does it symbolize writing from your deepest passions and beliefs, from where you feel the anger that something is terribly wrong? Could the roots of the word madness give us a hint to the answer?
Mad meaning: gemaedde or out of one’s mind, implying outside the typical collective views, seeming to be foolish and stupid. It comes from ga-moita and the latin mutare, meaning to change. Mad births also from migrare, the changing of one’s residence. An interpretation might be imagined to read: “Writing from our foolish self, the one that seems stupid and not agreed upon by normal views, leads to a possible change in direction from the current consensus ideas and theories. It opens us to the ability to change where we are sitting in our resident beliefs and see the world from different vantage points.” It may take a touch of madness to do this.
So, I believe that all of us writing for MIA do so from our foolish and mad selves, hoping to bring to the debate table the missing viewpoints that have been left out of psychiatry’s consensus ideas.
A man who never followed the consensus beliefs on psychosis was my friend John Weir Perry. He was a psychiatrist, trained at Harvard, who in the late 1940’s went to Zurich, Switzerland to study and analyze with CG Jung and was one of the first of Jung’s students to come back to America and help start the Jung Institute in San Francisco. He had already begun to question the current treatments of schizophrenia long before while still in medical school, as at that time the use of insulin coma was quite popular. Later in the 1960s, he along with Julian Silverman started a project at Agnews State Hospital, treating first episode psychosis patients without medication. This later became the Diabasis project in San Francisco, where people with first episode psychosis were treated in a home in the city that was unlocked and the success of this is well documented in his book, The Far Side of Madness. Dr. Perry went on to write multiple books about his ideas including: The Self in Psychotic Process, The Lord of the Four Quarters, The Heart of History and Trials of the Visionary Mind.
I first met Dr. Perry briefly in the late 1970s, when I was doing a psychiatry rotation in San Francisco. I had been at an art therapy consultation at the clinic where a Jungian analyst was explaining how he was able to read from the patient’s artwork, by the colors chosen and the fragmented borders, that her psyche was already predicting a psychosis weeks before it occurred. This was my first exposure to Jungian thought and because I was so excited my preceptor told me she would introduce me to John Perry and have me see the reopening of Diabasis.
I didn’t see John again until years later, in the early 90’s when we met at a conference in California exploring alternative views for understanding and treating psychosis, featuring Stan Grof, John Perry and Arnold Mindell. I was asked to give a small seminar on the work from my residency, treating first episode psychosis with psychotherapy and without medication. John and I bonded at that time over late night wine and wonderful conversations about this treatment and the state of the field. We remained friends until his death.
In my next article I will talk about Al de Half, a fictional figure who appeared in my dreams years ago, telling me that the Comprehensive Textbook of Psychiatry was not the right book to be studying if you wanted to know how to be of help in psychosis. His bible was instead A Separate Reality by Carlos Castaneda.
I will also tell about the last time John and I met, sitting up again late into the night, this time at my home, talking about the dream of Al de Half and the paper I was writing for the conference we both were to speak at the next day. It was a conference on the Oregon Coast with Arnold Mindell and Joe Goodbread, exploring Process Work and Jungian methods of treating extreme states of consciousness. That was more than 20 years ago, and yet that conversation is still remembered vividly today; not only for John’s mentoring friendship, but also because of the hints that Al de Half gave to both of us about his separate world. I will look forward to sharing these with you in my next writing.