“Heartbeats of Hope: The Empowerment Way to Recover” – A Book Review

Ron Unger, LCSW
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We seldom have a chance to hear from someone who combines the perspective of a longtime psychiatric survivor and activist with that of being a psychiatrist! So, I was happy to read this heartfelt book by Daniel Fisher, where he brings together an integrated vision of what a wise and humanistic approach to mental and emotional crisis might look like.

Heartbeats of HopeDaniel starts by sharing his personal story, and that fascinating story alone is enough to make the book worth reading! He outlines a variety of factors in his earlier experience that set him up for having a severe crisis, such as his taking on the role of “golden boy” in his family, the sexual abuse he received from a teacher, and his later efforts to suppress his feelings which he believed were interfering with his thoughts. He then describes his “descent into the maelstrom” which left him mute and catatonic, followed by his being hospitalized and diagnosed with “schizophrenia.” And then he describes what led to his recovery.

But few who recover become psychiatrists! Daniel clarifies that this was not easy, as most psychiatric training is not set up to support those with humanistic inclinations, much less psychiatric survivors. He wrote that “it seems that professional training and elevation in status tends to select out the qualities most essential for helping another human being through a crisis.” But then when he sought support through a peer group, he found that now it was being in psychiatric training that was creating a barrier to fitting in and getting support! The Mental Patient’s Liberation Front (MPLF) informed him that he could only attend as an ex-patient, not as a psychiatric resident, but he felt unable to go as only half of himself. Later, a group formed called Friends of MPLF, and he was finally able to get the support he needed and meet people like Judi Chamberlin, with whom he later collaborated.

While “schizophrenia” is often thought by professionals to be a “thought disorder,” Daniel’s story illustrates the way difficulty in relating to affect, to feelings and emotions, can really be at the root of the apparent “symptoms.” As Daniel recovered, he learned to accept his feelings and his relations with others as central to his existence, and then this perspective informed his treatment approach once he did become a psychiatrist.

Regarding relations with others, he wrote that “something about being in deep relationship allows the variety of my seemingly independent selves to come together into a community of selves that I call my self.”

The later parts of the book explore what mental health care focused on healing looks like.  He emphasizes supporting personal empowerment, the promise of dialogical approaches, and the basic process of attunement through “emotional CPR.” Detailed examples of how these approaches work are included.

As I read the book I noticed myself disagreeing with only one significant point. That was in regards to a statement made that a person does not have to be off all medications to show “complete recovery” from “mental illness.” This notion is supported by pointing out that many in our society take psychiatric drugs but maintain their social role and are not considered “mentally ill.”

I found that way of talking about the issues to be unclear and unhelpful. First, I don’t think we should frame anyone as being in recovery from “mental illness” as that term is, as Daniel himself admits, not very helpful to describe what people go through.  And if we describe it instead as being a mental and emotional crisis, then it seems a bit contradictory to say that one is “fully recovered” from such a crisis and yet still in need of medical assistance. It may be fine to point out that a person is no longer disabled by the crisis and is functioning as well as many who have never been hospitalized but who are taking psych drugs themselves to cope with less extreme mental or emotional difficulties; but I would reserve the term “full recovery” for getting to a place where no further “mental health” assistance is needed. I think this is important, because we need to make it clear in the way we speak that outcomes where drugs are no longer needed are possible. This is essential if we are to fight back against the system’s tendency to hook people on drugs without much hope of ever getting off. Claiming that people still reliant on drugs are already “fully recovered” suggests that no further recovery is possible, and thus tends to cut off hope that getting off the drugs successfully might be possible.

There are those of course who would frame the whole concept of “recovery” as unhelpful, and as a term co-opted by the mental health system. I would agree that there are problems with the term and with the way its meaning has often been twisted, but I think it remains important as something to talk about when offering much needed hope to people from whom almost all hope has been stolen. “Heartbeats of Hope” makes a strong contribution to a possible future when hope for recovery will be kept alive within mental health treatment, and people in crisis will be offered human relationships and help in resolving the crisis, instead of being offered the currently popular mix of coercion, lies, and attempts to use drugs to suppress any and all unwanted responses to life difficulties.

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40 COMMENTS

  1. a person does not have to be off all medications to show “complete recovery” from “mental illness.”

    I believe I have completely recovered from alcoholism and addiction but I still party pretty hard sometimes if and only if I know its going to be a fun time. I guess that’s off topic a little but I am completely recovered but the psychiatric and AA version of recovery says otherwise. Maybe I should leave AA out of it they only suggest total abstinence but the psychiatric version calls it a relapse.

    I am so brainwashed by the whole thing, do I post this? A few people know my screen name … He is not sober not in recovery he is still sick some would say.

    That word recovery is so tricky.

  2. 1st objection. My, oh, my, but isn’t Heartbeats of Hope a sappy title. Get back to me when you aren’t addressing your book to saps. Look up a slang definition for sap, and you will see what I mean. The acronym ‘sap’ is for ‘sad and pathetic’, and applies to fools.

    I always saw recovery as a matter of recovering from the mental health system and its abusive mistreatment. Recovering from a personal crisis? I don’t think so. Crises are things people resolve rather than “recover” from.

    Now how do we “cure” all these “mental health” professionals from their professional ‘calling’ disorder, that is the question.

  3. Hi Ron,

    Thanks for the review. Daniels experience is very inspiring.

    As regards medication my main problem was with the disabling side effects and severe adverse reactions, but I also found the drugs very dependency forming.

    I came off injection type medicine in 1984 and I tapered with oral medication. By 1990 I was consuming 25 mg/day* of mellaril (a dose suitable for a 7 year old with hiccups). In 2005 I was switched to 25mg /day Seroquel, and I consumed about one quarter of this and then eventually nothing.

    I was getting worrying “drops” on heartbeat with the Seroquel; plus my chest was bright pink and the rest of me white, on awakening.

    *I believe Seroquel at under 150 mg /day is considered non thereuptic for “SMI”.

  4. Thanks Ron for great review of my book. Here are my thoughts about the question “can one have recovered completely and still be on medication?”
    First I know of a number of people who have recovered a full life though still take a smaller than usual dose of medication.
    My point is that recovery is defined by seven characteristics especially having control over the major decisions of one’s life and passing as no more disturbed than neighbors (see http://www.power2.org). On page 130 I state:”The primary distinction between a person who is labeled ‘mentally ill’ and a person labeled ‘normal’ seems to be whether the person has experienced a major interruption in the development and life that resulted in others making decisions for them.” So by my paradigm of recovery of life, taking or not taking medication is not the main criterion of being labeled mentally ill. After all there are many in our society who take medication but maintained a major social role and therefore were never labeled “mentally ill.”
    As far as the title being sappy, as Ron points I have found that recovery of my life depended on my retiring my capacity to feel and experience my emotions.

    • Hi Daniel, perhaps the real question is an existential return to the era of alienist questions of what Maslow called ‘homo-normalis-rationalis, who Reich said where emotionally evasive and dishonest compared the emotional authentic desire of the so-called schizophrenic. And from R.D. Laing’s perspective on our human post-hypnotic trance state, induced during the behavioral initiation period of infancy. Does, the mistress of all our Muses. memory created a post-hypnotic suggestion, as we see the objects of the material world & instantly name it?

      From Laing’s question about the possibility of ‘love’ in a know thy-place, paternalistically organized the social world, actively block, by the base affect-emotion of fear, the existential questions of humanity that needed to be asked right now. Like, is the word ‘heart’ my experience of my heart & do I act-out the sin of self-ignorance, by simply taking my experience for granted?

      During infancy, we explore the material world by grasping objects and experiencing them with a visceral sense that is a mix of our five senses capacity to know reality. Without realizing it, do we grasp at words, with our minds in the same sensate, experiential way? Imagine a shift in the tactics of political experience, by humorously asking mind doctors an existential question, based on Socrates retort to emotionally adolescent critics; Know Thyself.

      And imagine a Marilyn Monroe lookalike asking in that famous “Mr. President,” super-sensual way, a question of existentially conservative, hierarchically dominating men; So you know the mind’s of others and being human, you naturally can walk and talk. Can you say a few words about ‘how’ (Reich’s most intuitive word of human experience) you do that?

      I asked this question of a young American male, still too young to fear loss. He instantly began to move his right foot forward, as his right arm moved upwards, then stopped (a flight-fight-freeze reflexive response?), and being an authentic type, he said; I don’t know. I’ve made a comment on Michael Cornwall’s last blog about gently turning the tables in an existential way, by raising my hand before my face (Gestalt awareness of foreground/background phenomena; saying the ‘hand’ then wiggling my fingers to ask, is the word ‘hand’ the experience of my hand. The non-plussed look in response hovers on the event-horizon of an epiphany.

      Then, just as Reich describes in ‘Character Analysis’ the habituated muscular/vascular armoring blocks it. Which, from the Buddhist perspective on Void mind, is, I suggest, the fear of ‘self-emptying’ Jesus alludes to on his ‘conscious-cross.’ Is it time to turn the tables, through this community’s lived, experiential wisdom, that we are not mad or ill, we just experience the call to awaken through the nervous system’s evolved or created wisdom. And finally, do know the wise story of the ‘handless maidens’ who literally create so-called history?

      I invite readers of this thread to google the ‘axial-age’ and follow their heart’s to current theological and philosophical debate, on fate & destiny. Marvel not, when I say you must be born again. -The Nazarene.

      Yeah but ‘how?’ cry the youth of today: “Jaspers described the Axial Age as “an interregnum between two ages of great empire, a pause for liberty, a deep breath bringing the most lucid consciousness”. It has also been suggested that the Axial Age was a historically liminal period when old certainties had lost their validity and new ones were still not ready. -From https://en.wikipedia.org/wiki/Axial_Age

      Some witty street philosophers ask; are you barking up the wrong tree, of knowledge? While the Buddha sat down on the right side of the tree & the Christ said; cast your net on right side, my shepherds to the sheep.

      While in ancient India, where Val Resh lives, the brain is known as the. ‘net of gems.’ Don’t go sowing seeds in the field of consciousness now, though, will you? Or gleaming in the field of consciousness and sorting the wheat from the chaff either, like Ruth in a certain book, way too old to take seriously. Parables of the human condition are just Myths, aren’t they? Just like the myth that we really do know ourselves.

      What a heroic journey the human story is.

  5. The Mental Patient’s Liberation Front (MPLF) informed him that he could only attend as an ex-patient, not as a psychiatric resident, but he felt unable to go as only half of himself. Later, a group formed called Friends of MPLF, and he was finally able to get the support he needed and meet people like Judi Chamberlin, with whom he later collaborated.

    Don’t know what this implies to the author, but it is an approach regarding survivor activists’ relationships with professionals which made sense then and, I believe, makes sense now.

  6. Hi Dr Daniel,
    I’ve seen you speak before on video. There’s a lot of resources being invested into a cure for “Schizophrenia”. Could I ask you what you would consider a cured person to be – what would the person have to achieve to be cured?

      • Then recovery is not about cure but about recovering a full life in the community.

        What if one lives in he U.S. and there is no “community,” and few preconditions for a full life, and the available schools and working conditions only compound the problem?

        • Is the life glass half full or half empty? Wait a minute, I think we’ve still got a pulse. Let’s give him the benefit of the doubt and say “half full”.

          Community is a participant sport, and it starts wherever you happen to reside. I think community is something you help make, but in order to do so, you have to first see it as important.

          Marginalized is fancyshmancy for scapegoat. Even marginalized creates opportunities for community. Turn the tables, and we’re getting somewhere.

  7. First, on issue of recovery of full life in community, I agree that there has been a breakdown in community and I have worked within my neighborhood to develop community through a cooperative day care etc.
    second, I make a distinction between recovery as a restoration of one’s place in society compared to healing from trauma which led to label of MI

  8. Dialogue helps both ways as meaning is being created. The way I distinguish between recovery and healing I feel is critical. To continue your tennis player analogy, I see recovery of full life as a sociopolitical term describing her position relative to other players and the association of tennis players with its rules whereas healing is a more psychophysiological description of her intrapersonal struggle. So using your tennis player analogy: she had a trauma to her arm and psyche and as a result she could not compete well enough to qualify for membership in the association of players who qualify for major tournaments any longer. With rehab, belief in her by others in the qualified group, and a brace she fully recovered her membership and once again qualified. Her arm continued to heal even after she had fully recovered her position as a member of the association. She became more sympathetic towards others who struggled to stay within the qualifying range, providing them peer support. During the healing she resorted to an earlier style of play but as her healing progressed she could return to developing new moves she never knew herself capable of. This was a trauma activated growth of her capacity.

  9. This issue of whether people who take medication should be counted as being in recovery is a very unfortunate one from my perspective. I believe that as a culture people who experience madness or what I prefer to call special messages are extremely diverse. I think that historically we have been divided by so many different labels that we as a people aren’t seen as a culture. And what’s worse we aren’t treating each other as brethren when we clique up and reject people who decide that based on their experiences that they want to be on medication.

    At least for me, recovery from special messages was so hard, I needed to use all my resources, my strengths, my passions, my inclinations in order to recover. I really don’t like being judged because I chose to continue medication. There are things I am blessed with and things I am not, but I was able to come back, and I am grateful.

    Being in message crisis was a degrading and dehumanizing impoverished experience, and I feel further dehumanized when someone who doesn’t the least bit about me makes a decision to exclude me because I do not measure up to their standards. I believe that some people may have gifts and blessings to get off their medications and I am happy for them and some people may have been so hurt or be facing enough obstacles that they cannot, or choose not to.

    I work with some very deprived individuals many of whom have lost their freedom to institutionalization. The horrors that they experience are hard to bear witness to and they are exactly what I experienced for two and a half years. I am compelled to continue to break through and it works and we have a valuable community with great people in it. But are we to create a caste or class system that is choosy about who we honor. If someone was unsupported and homeless instead of getting a free pass to school, I do not think that they should be penalized for it in a recovery community. Mad diversity is so complex. I have been very excluded and really have not found shelter from it away from the community in which I work. I am sorry but it hurts dearly. At the same time I am so lucky and privileged to have found some stability in my life and I am not taking that for granted.

  10. Thank you for response. I just feel when someone who doesn’t know my history and situation says I could be better healed like they are it implies that they know something that haven’t yet learned. This has led me to feel marginalized in groups and adds to my isolation. But you are right, my language was exaggerated and hearing your response helps me take more responsibility for my feelings and helps so thank you. I am suppèr sensure to discourse that excludes.

  11. “Recovery” implies that someone is suffering from some kind of an affliction, if not even a moral defect.

    For anyone who looks at things this way, the first thing they need to do is decide that they will never in any way shape or form, disclose their feelings to anything like a therapist.

  12. By talking about these things as ‘Recovery’, like say recovering one’s sanity, or recovering from alcoholism, or recovering from child abuse, or recovering one’s balance or one’s momentum or social standing, we are still turning it back on the survivor, making like it is their problem and they that need to recover.

    This is the problem with the concept, because it turns the experience of injustice into a self improvement project.

    People who drink, drink for reasons, mostly because their feelings of injustice are not affirmed.

    People who have survived the abuses of the family, suffer everyday because they are always being told that they are deprived and that they have to deny their feelings and to stop telling the truth.

    People who have had their social identities shattered are told to deny and to try to fit in.

    The concept of recovery, just like the concept of psychotherapy, is completely bogus. And so if one wants to be able to live, they need to instead learn how to politically organize and fight. And the first place to start is to cut off all therapists, and to make it known that their actions are not welcomed, and to find ways of talking political actions against therapists.

    And any therapy performed on a dependent child has to be considered forced. And if the child is not being represented by an attorney in court, then that therapy is an extreme form of criminal child abuse. If it is not being punished under US law, then it should be prosecuted under international law. Just as a minor cannot consent to sex, a minor cannot consent to the mind fucking known as psychotherapy.

  13. Some people are teaching children how to refuse to submit to corporal punishment, in the schools. They are teaching them who to call, and just how to refuse. And they seem to be trying to have people ready to appear on site to intercede. And this is often being done when the parents have signed a consent to corporal punishment form.

    I can provide more info about this.

    Well we need to be doing the same thing about psychotherapy, teaching children how to resist it, no matter how they ended up in the therapists office. First we need to do role playing showing them what the therapist is and what they do, and how they will groom clients to gain their confidence, and then how they use that against them ( what they call ‘transference’). And then we need to be teaching children how to resist, how to get out of the office, or how to stand their ground and make sure that the therapist knows that they are not afraid of them, but that they detest them, and we need to have people ready to intercede on site, and who are not afraid exercise the power of Citizen’s Arrest, and then have lawyers on standby. And we need to make sure that children know about all of this.

  14. Ron, I live in the same world as you and everybody else do. One of the MO’s of psychotherapy is to show pity. This is what you are trying to do now.

    It is not going to work, because I know that the only way to deal with a psychotherapist is to defend myself.

    I know that many people believe that psychotherapy has really helped them. Many people feel the same way about psychiatric medication, and about alcohol, cocaine, and heroin too. I’m not actually suggesting prohibiting the practice of psychotherapy between consenting adults. No, I just want to de-license it and educate people against it. And children must be protected from it, except when they are being represented by an attorney in court.

    It is all just abusing the survivors of abuse, trying to make them believe that their desire to fight back is an illness. It is not that they have endured hardship, it is that they want to fight back which the therapist finds so alarming. If the therapist opened themselves to that, then they would have to face their own pain. The reason the therapist is a therapist is that they have found a way to rationalize not facing their own pain.

    Its like Jeffrey Masson writes about both conventional and eclectic psychotherapies, “The practice of psychotherapy is wrong because it is profiting from another person’s misery.”

    Fortunately some are starting to get wise to this:

    http://website.lineone.net/~vex/How%20Therapists%20Abuse.htm

    http://www.wmlawyers.com/firm-highlights/publications/therapist-abuse-and-therapist-malpractice-cases/

    And they have recognized that ‘transference’ is the key juncture when the therapist has the most power to do harm.

    http://www.wmlawyers.com/firm-highlights/publications/a-comprehensive-overview-of-therapist-abuse-litigation-in-california/

    Now, admittedly, these lawyers are still saying, Good Therapist – Bad Therapist. I don’t go along with any of that. But at least these lawyers are suing some of them.

    So about transference, Freud saw that at some point in the psychoanalysis, most of his clients became extremely angry with him. And of course, because they have talked themselves out only to find that their analyst does not stand with them, he offers pity, but he stands with the parents and with existing authority.

    So Jeffrey Masson, former curator of the Sigmund Freud Archives writes about this:
    https://www.amazon.com/Against-Therapy-Jeffrey-Moussaieff-Masson/dp/1567510221

    At some point, the therapist will have let the client talk themselves out and then start making excuses for violators and just telling the client that no matter what, they just have to live with it and there is nothing which can be done.

    And Ron, you are doing this already. No one should ever put up with that. I certainly don’t. I mean, this is the sort of thing anti-rape activists have always called second rape.

    But therapists try to do it with every client. Once you make the issue be about trauma and bad feelings and memories, you are making it about the client, instead of about the abusers and societal injustice. You are saying that their non-denial is a moral and medical problem.

    And then when this therapy is being done on a minor, when they are not being represented in court by an attorney, but it is just being done at the behest of the parents, there are not words to describe what an outrage that is, or why the law must act.

  15. Ron, medical doctors do indeed help in the healing of broken bones. And that is my point about why psychotherapy is wrong. You folks are taking people’s experience of distress, their experience of injustice, and making it into something like a broken bone, something which needs to be fixed.

    So you are taking those who are marginalized, like the poor and children, and saying that their own experience of distress is an injury. Not the cause of the distress, but their experience of the distress.

    So if we can help build on the court cases which make this tortious, we can then start contacting your clients and opening their eyes and helping them to see what you do to them. We should be able to get them to sue you.

    And if we can follow up using sidewalk protests to put you out of business, then that will mean that many less parents driving their child to a therapist because that is how they manage their relationship with the child. Sure people fool medical doctors, MSBP. But with doctors who already want to turn the experience of distress in a victim into an injury or illness, and so they don’t need to be fooled, that is far worse. So the sooner you are out of business, the less familial child abuse.

    Mandatory reporting was supposed to solve this problem. Sounds like most in public practice do report. But with those in private practice its a pact between the therapist and the parents that there will not be any reporting. After all what could possibly be wrong when a child is delivered to the office of a therapist believing that they have something wrong with them, and so that the therapist can exploit this vulnerability and break them?

    I’m not suggesting that the practice of psychotherapy between consenting adults should be criminalized, I’m only saying that the government should not be issuing licenses. This does nothing to protect the public, it only means that our most vulnerable are being made subject to abuse without the recourse of legal redress.

    So if we can revoke the licensing, and then start suing more and more psychotherapists and then follow up by running them clean out of business, then that will be that many less people being abused.

    And then if we can go to the next step and show specifically how therapists are targeting children and marketing to their parents, for the treatment of non-existent illnesses, and in order to help the parents break the child’s spirit, then we should be able to get that prosecuted in International Court as Crimes Against Humanity.

    “Crimes against humanity are certain acts that are deliberately committed as part of a widespread or systematic attack or individual attack directed against any civilian or an identifiable part of a civilian population.”

    https://en.wikipedia.org/wiki/Crimes_against_humanity