I was four years old when I first wanted to run away. My earliest dreams were of flying: my parents and teachers shouting as I ran with arms outstretched, soaring upwards, heading for woodland, friendly birds and safety. When those dreams receded, alcohol took over in my teens, squishing away high levels of anxiety and loneliness, like a giant marshmallow. Yet the trauma remained intact and present beneath the soft folds of ethanol.
The feelings of disconnection were triggered by my father, a distant man, with a terrible temper. The slightest thing would set him off and mealtimes were the worst, when my two brothers (Roy, my twin, and Eric, my younger brother) and I were subjected to his laser gaze. Sarcastic comments would pour out, his blue eyes piercing our innocent skin. On many nights, my parents had heated arguments — sometimes Roy and I crept out from our bedrooms and sat shivering on the landing, a sliver of light on the hall carpet, hugging our knees as the words slammed to and fro. Occasionally, there were slaps: they were the signal to head for bed.
We had no relatives close by, no one to talk to and find out “are your mum and dad like this, too?” My father’s family were in the west country and my mother’s in Norway. Fragmented, our nuclear family sat in a pool of anger and sadness.
Dad was a highly intelligent aeronautical engineer, and his mood swings must have been devastating to the ‘normal’ him. Around the time of our mother’s cancer, he started scapegoating Eric, a much loved, beautiful son. Jealous of the way we danced attention on him and his funny ways, soon dad blamed Eric for everything bad that happened at home. He was frequently sent to bed early for some imagined slight. I saw this and challenged my father — at just five years old. Told to mind my own business, I coped by singing myself to sleep at night, rocking my head on the pillow. And grinding my teeth.
Afterwards, I took to swallowing nails. The metal inside my bowels meant hospital stays, where I felt safe and life was sane. I managed this three times: the third time after mumps, when I had a lymph gland removed, because I’d refused the medication. I was now seven. Only my early belief in a compassionate Jesus, a male who cared for children, provided any comfort in a stormy family.
The disconnection worsened when we began moving with my father’s job. Eric’s laughter and japes increased to hide his anxiety. His favourite trick was running up the stairs and jumping from our parents’ bedroom window onto the lawn below — a drop of twelve feet. I have no idea where my mother was when this was going on. After three moves in the UK, we returned to our home in Hemel Hempstead — I hoped this would be for the last time. A year later, we moved out to Addis Ababa, Ethiopia, after my father got a job with Ethiopian Airlines.
Unusually, it was a happy time. Dad was finally relaxed and he and my mother went out more as we were older and had the ‘sabanya’ — night watchman — to keep an eye on us. Eric blossomed in the heat, a yellow headed sunflower amongst the coffee coloured, doe-eyed Ethiopians. My fledgling faith was nurtured there too, at a Catholic girls’ school. I even had the privilege of sitting beside a princess: Sihin Asfaw Wossen, one of Emperor Haile Selassie’s granddaughters. But inevitably, dad wanted to move back (his boredom threshold was exceeded every two to three years). I was sad to leave that exotic, friendly country.
Away from the heat, Eric wilted and his obsessive black paintings of skulls, looking charred by fire, and regularly disappearing on his own were the hallmarks of later collapse. When dad announced we were emigrating to South Africa, I pounded his chest with my fists, shouting: “I hate you, I hate you, I hate you.” I’d wanted to stay on at school and go to university — my plans were being wrecked, yet again.
South Africa was our nemesis — it was everything we hated as a liberal, egalitarian family. Dad became a racist to fit in, along with Roy, a complete contrast to Ethiopia. My mother, Eric and I flew the minority flag for tolerance and compassion. Eric’s tiny resilience disappeared after being muzzled in class for failing a spelling test: a chalk-filled duster was stuffed into his mouth, his lips sellotaped, and his hands tied behind a chair. Horrific! Three months later, he began experimenting with marijuana. He was just 12.
Eric became addicted to cannabis at 14, running away at 15 — causing mum’s breakdown — and went into rehab at 16, after which dad had a stroke. Around that time, I began to have prophetic dreams and the ghost I’d seen in my childhood began showing up again — not frightening, but comforting. My belief in a merciful Jesus was sacrosanct. Somehow, I managed to complete my matriculation and graduate with good grades, and in May 1972, I jubilantly left South Africa and my dysfunctional family behind.
Returning to the UK six months after me, Eric chose heroin for annihilation. Visiting him in various hospitals with money and clothes became a regular habit. A year after moving back, dad became convinced people were following him and listening in on his phone calls: he believed he was under surveillance by M15. My mother managed to get him to hospital, where he was diagnosed as paranoid schizophrenic. He had ECT and medication, which made him drool and his hands shake. He was 54, but looked a lot older. But it mellowed and humbled him, for which I was thankful. He began being kinder to Eric.
Hemel Hempstead beckoned my parents back to familiarity and old friends. Eric stayed well away, drifting into and out of casual jobs. My parents were pleased when he was accepted by another rehab: Phoenix House in south London. Eric became his old, enthusiastic self, but a year later, he was back on heroin.
Alcohol helped me process the pain. After dad’s death, my boyfriend (now husband) and I managed to track down Eric at a London squat. He made it to the funeral, and moving back in with mum gave him the happiest, most stable years of his life. She was an incredible woman and very stoic, recognising that he needed a non-judgmental home. Eric became a registered methadone user and worked full time. Harm reduction, as it’s now known, was good for him.
When my mother lay dying from terminal cancer, I had to pull together the very scattered family (we had two half sisters, Jackie and Gill, both relieved they’d been at boarding school, away from most of the verbal abuse). I knew that I’d somehow have to find the energy to cope with Eric — Roy wasn’t interested, he found him too frustrating.
After mum’s death, Eric spiralled out of control. He was lucky enough to be in public housing and we helped him move to a smaller apartment. I would take him out for meals and phone regularly. Other times, he’d ring me, deluded and faint — there was always someone causing him major problems. He told me he recorded all his phone calls. I couldn’t discern reality from his fantasy.
In anguish, I made it my mission to uncover the family genes, to find out from where the family dysfunction had sprung. Tracing my maternal side, I discovered there were addictive genes which had re-emerged in the 1960s, through Eric and two male cousins whose childhoods had been very stable, yet all three became addicted to heroin. My Norwegian aunt and uncle cried as they recounted their sons’ overdoses: a visit to their graves in 2010 was a shared weeping. My cousins still love and talk about them.
At 49, Eric admitted himself to a local psychiatric hospital, where he was also diagnosed with paranoid schizophrenia. This time, I insisted that Roy and my younger half sister, Gill, accompany me. He refused to see us, but I gave his team a written account of why he had become an addict. He’d been unable to form the words to blame dad for all the abuse: even after 45 years, he’d wanted to protect him.
On my father’s side, there was no mental illness — it had just emerged in him. He rarely drank, the mood swings were his maladaptive brain’s call for help. He’d been his mother’s blue eyed boy, just like Eric. Prodigal sons, both.
My quest became an obsession, and I followed in my dad’s footsteps to Ethiopia, Israel, Norway and around the UK. It felt as if some deep, much needed ancestral healing was going on. My prophetic dreams were in full flow during this period: 90% coming true. I inhabited a world of symbols and synchronicity — not mental illness — a direct result of childhood cruelty.
(Interestingly, I wrote a book about my former classmates from Addis Ababa, inspired by another dream I’d had in 2000. What was astonishing is that everyone I told about the dream believed it and kind strangers in ten countries helped me track down the majority of the women. The resulting book An Ethiopian Odyssey was published in 2006, in which I included my spiritual experiences and the extraordinary synchronicity I’d encountered. I had the great honour of giving a book talk at the UN headquarters in New York in 2007, hosted by the Ethiopian ambassador. Ordinary people accepted as normal what some professionals call ‘psychosis’. The book sold in 22 countries and raised over £2,000 for WaterAid.)
Eric, happily, had four stable years after he met a kindly older man, Stan, who became the father he had never had. He visited many addicts in hospital — all abandoned by their families. A kind soul until the end. He fell to pieces when Stan died and told me there was nothing else to live for. Eric committed suicide at age 54, on Good Friday, 2009.
Roy, my twin, then died in 2013, at just 60.
Inevitably, my battered soul wanted to give up. I was a hair’s breadth from a breakdown: four family deaths in seven years and almost five decades of trauma and addiction. My husband and son were also affected — we were deeply fragmented. Many friends avoided us — the genetic trauma looked like a ‘curse’ to them. The only thing that helped were my hopeful dreams.
When I was really ill in 2012, I could feel my brain eating every word I heard on the evening news. A year after my twin’s death, I stood in a supermarket and felt my body disintegrating into a thousand pieces. Running for the door, I knew I needed help, fast. I found a counsellor and was prescribed Sertraline — 50mg — but I tapered off after 3 months, as it made me feel ‘whoo whoo.’ No real improvement. The next year I found a consultant psychologist who wasn’t much better. Both found it hard to accept my prophetic dreams and deep Christian faith.
My soul knew it needed the right teacher and helper. Fortunately, I read Russell Razzaque’s book Breaking Down is Waking Up in 2014, and attended Open Dialogue’s first UK conference in 2015. I also stopped drinking on May 1st, 2015: the sixth anniversary of Eric’s funeral.
Open Dialogue: Across the globe, the majority of people who have psychotic experiences and go to mental health services are likely to end up on antipsychotics. Open Dialogue aims to avoid long-term use of medication and hospitalisation. It was developed in Tornio, Western Lapland, Finland by Jaakko Seikkula and Markku Sutela in the early 1980’s, as a social network approach to mental health difficulties. The Open Dialogue approach explores the context of patients’ experiences to help create meaning. It brings together all those who are important in their lives, from family and friends to professionals, and aims to offer a coordinated and consistent approach throughout the life of the problem: this could be weeks, months or even up to two years.
From the first day of the crisis, a team is formed who remain with the patient throughout their treatment. The OD team involve the whole network to understand the crisis from all dimensions. Many patients are treated in the home, as this is where most are comfortable. They ask questions and at a suitable point, reflect in front of the family and discuss with each other what they are hearing and feeling. The focus is on the gentle process of an open dialogue, in which no firm conclusions are drawn for the first few days, because the family’s story is allowed to emerge naturally, in their own daily language. The polyphony becomes visible. Open Dialogue’s ethos is: “there is no us without you.” In some instances, there is no need for medication. Working dialogically understands mental health difficulties, and particularly psychotic experiences, as expressions of distress and trauma that haven’t yet found words and meaning. A dialogical approach aims to work with the person and their experiences: it avoids labels.
Research into the effectiveness of OD, versus treatment-as-usual, showed promising results. Clients diagnosed with schizophrenia were hospitalised significantly less compared with the control group, an average of fourteen days per person compared with one hundred and seventeen over a two-year period (Seikkula et al., 2003). Only 33% used neuroleptics during some phase of treatment, compared with 100% in the comparison group. Families were actively involved in all of the cases, having an average of twenty-six meetings over two years. When comparing outcomes, OD clients diagnosed with schizophrenia seem to recover better from their crises: 24% of clients have one relapse, in comparison to 71% of the control group. Only 17% of the OD clients had at least occasional mild symptoms, compared with 50% in the comparison group. As many as 81% had returned to full employment within two years, compared with 43% in the comparison group.
International interest in Open Dialogue began in the early 2000s and today, training is taking place in Australia, Czechia, France, Germany, Italy, the Netherlands, Norway, Sweden and the US: California, New York, Massachusetts and Vermont. Open Dialogue UK was founded by Nick Putnam in 2012, and was the first to offer the full Open Dialogue training — a three-year programme — outside Finland. Major research projects have also been approved in the UK, Italy and US (Atlanta.) Click here to read more about the latest, exciting developments.
The dialogic, family systemic therapy I read about in Russell’s book made total sense: the listening and sitting with what emerges, not labelling or judging it. Just mindfully observing, and repeating the patient’s phrases: very life-affirming, and letting the patient control much of it. It matched my beliefs about the cosmos, David Bohm’s ‘unfolding meaning’ and the synchronicity which my heart holds as true. (I love Jung!)
In 2016, they introduced “Dialogue First” for patients who weren’t in crisis, opening it up to NHS Trusts across the UK, via GP recommendations. (Two stipulations: not receiving any other NHS therapy and travelling to their offices in east London.) That July, I was one of the first patients on this free NHS treatment. Even more fortunate, Russell was my lead clinician!
The key differences I experienced were: having a team to listen and observe, only ending the session when I was ready (the first lasted almost three hours) and sharing their observations with me, openly weeping with me and showing gratitude for what they were learning. Sublimely humane.
Gill, my half-sister, attended along with a good friend. She attested to our father’s cruelty and the times our mother had tried to run away. Slowly, slowly, Russell and his team helped me expose the real childhood trauma, and gradually rebuild my shattered, grief-stricken psyche.
I spoke about my experiences at the 2017 Open Dialogue conference, along with three other patients. Afterwards, two mental health professionals accused me of being mentally ill — in those few minutes, I saw the deep problem. The unwillingness to accept people’s vulnerability as part of being human. I firmly told one, “You may consider me mentally ill, but I see myself as spiritually well.” He had no answer — I’d exposed his mechanistic thinking. I am not a robot!
Today, I’m part of a small group of OD Champions (mostly parents whose children have been in and out of crisis), focused on making Open Dialogue the preferred treatment for mental illness in the UK. We are determined to re-educate professionals and over time, society, about the need for a much gentler approach to shattering times.
There are periods when anyone can become unwell, because they’re so grief stricken — naturally — about events, and sometimes people’s cruelty, often not of their making. This manifests in all kinds of ways. I don’t label it, because it doesn’t scare me. Instead, it’s taught me compassion.
I’m now retired and mentor people to quit drinking. My deep depression and anxiety have virtually gone. I buy food for homeless people, wherever I travel. Today, I have an abundant life and share my abundance with people cruelly stigmatised and marginalised. We are all frail and fragility is part of the human condition. Society has long conditioned us to scapegoat others, like dad did with Eric. This is where the insanity lies: the stigmatising and scapegoating.
In the years ahead, I will continue sitting with and affirming those suffering distress. I’ve been there and know how dark it is. My darkness is utterly me, where my light also resides: the eternal Yin and Yang. No internal war, just ego and soul collaborating.
Looking back, it was third time lucky for me. I never became part of the mental health system — I was too wise after my dad’s and brother’s experiences. I had Valium in 1972 (flushed away after three days) and then Sertraline; nothing else. The voices, visions and prophetic dreams? All just part of healing myself. I knew my soul could find a way forward and I had the wholehearted faith it could — I just had to be patient. Thank you, Open Dialogue and all practitioners of this amazing therapy! Thanks, Eric and dad: you’re the reasons I am me. Today, I live in peace.
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.