Reflections on 25,000 Hours of Being With People in Extreme States


I’ve been face to face with people in extreme states as a caregiver for over 25,000 hours, beginning in 1980 until now.

I began that journey serving at a traditional private psychiatric hospital for a year and then on to a medication and diagnosis-free extreme state sanctuary. I also worked in community clinics, and on an outreach team on the streets with people in extreme states, all the while at a large public sector mental health system for 28 years. I’ve always had a private practice where I have also specialized in serving people of all ages in extreme states.

The central research finding of my doctoral research follow-up study on Diabasis House1 — John Weir Perry’s Jungian medication-free extreme state sanctuary — found that there is a discernible and very helpful “way” of being with people in extreme states that basically involves caregivers being openhearted and receptively compassionate while at the same time not imposing the pathologizing approach of the disease model of psychiatry.

In this essay I’ll try and share how that alternative  “way” of being with people in extreme states has expressed itself in my many hours with them, as I’ve personally attempted to practice my own idiosyncratic form of that “way” for almost 40 years.

I still spend time every week with people in extreme states and in all of the myriad forms of human emotional and spiritual/soul-depth suffering.

But I was surprised at that large 25,000 hour figure adding up when I made the estimate recently, as I prepared to lead a workshop called  “Compassionately Being With People in Extreme States.” I’ve often given that workshop during the past 20 years at places like Esalen Institute, graduate schools and for Peer Counselor training groups.

As a dissident Jungian/Laingian oriented therapist with a history of my own harrowing year of being in a childhood trauma-induced and archetypal-fueled extreme state in the 1960’s as a young man, I have never been able to understand myself or the people I was with who were in extreme states, or relate to them based on the theory and practice of the psychiatric disease model of human emotional suffering.

In some ways it might have been easier on me if I had been able to adopt that dominant paradigm that claims to know the causation of emotional and spiritual/soul-depth suffering by reducing it all down to bio-genetic psychopathology. I could have been more shielded and justifiably detached from encountering the intense emotional pain, and the often uncanny archetypal, psychic, spiritual/paranormal energies and presences that I instead opened my heart and psyche up to receiving. My heart opened up both unbidden and with devoted intention.

Tragically the psychiatric disease model approach creates and insures an inherently distancing and dehumanizing clinical response to the complex, multi-dimensional human emotional, archetypal and spiritual suffering that happens during extreme states — or during any of the kinds of emotional suffering that we all might experience at times.

There are good reasons why I never have viewed other people or myself through that objectifying, pathologizing lens.

First off, I can’t do it because I believe the psychiatric disease model is not valid or true, but moreover, the imposition of it constitutes an enormous, injurious failure of its own proclaimed mission. While that model claims the publicly sanctioned mission to alleviate the emotional suffering of everyone in society, it has enormously failed to deliver on that obligation. Instead it has harmed countless people, as I’ve reported here as part of the chorus on since 2012. In the name of professional medical assistance, countless lives have been dramatically shortened and lost, sometimes 25 years earlier than the national average. Human rights abuses such as ECT, forced treatment and medicating children have been carried out for many decades and continue to be inflicted every day.

Also, a huge reason why the injurious psychiatric disease model is so starkly exposed is because it stands out against the backdrop of irrefutable evidence about being with people in extreme states from the Agnews Project, Diabasis House, I-Ward, Soteria, Laing’s Kingsley Hall, Windhorse, and Open Dialogue.  All of those alternative services embrace a humanistic, compassionate way of being with people that also takes into account the impacts of the toxic social, economic and stratified matrix of the alienating and unjust social Darwinism surrounding us all.

Those alternative services clearly have supported the healing of the trauma that plays such a central role in the emotional and spiritual suffering that happens during extreme states.

But what I also want to share in this brief essay is something I’ve long kept to myself that I finally believe needs sharing.

It’s a confession of sorts, about me serving as a licensed mental health professional for almost 40 years while not truly being one at heart. I’m not an imposter, but when the door closes and I’m alone with someone who has come to me in an extreme state or other emotional pain, I never feel like I did when I was an army medic and felt sure about what my very defined scope of medical practice was in treating physical pain and injury.

In fact, before I sit down together with someone in emotional pain, I’m always anxious before we begin, because I’m always concerned that I won’t know what to do or say to be helpful.

I’ve never been able to internally adopt the role of being a trained mental health professional with an established treatment orientation that relies on a defined set of familiar, often codified interventions and “best practice” modalities.

I believe that taking on that kind of usual professional identity would have unavoidable negative consequences for me and the people I see.

Instead, when I’m with someone in an extreme state or other emotional pain who I want to be with to comfort and listen to, it feels to me just like being with a friend or family member who reaches out to me in their emotional pain. I’ve never been able to not feel that kind of very personal caring for the person I’m with who is suffering. Even when I’m with people who start off being angry at me, I just feel like I’m with a friend who is angry with me.

When I was a child there was so much I didn’t know and understand about myself and the other people in my family and young world. It’s strange, but at 73 years now, I often feel that same kind of childlike openness and naïveté as I listen intently to the unfolding story that someone in emotional suffering shares with me. I feel a personal caring for them in the face of the painful emerging emotional feelings and mysterious archetypal and psychic energies that find their way into words, imagery and dreams. I don’t want them to have to be alone during their suffering.

In writing this, I imagined it almost feels to me something like we’re two young friends who have ridden our bikes to a quiet place by the river and my friend turns to tell me about awful things happening at home — and they cry or pound their fists and yell in anger while I just sit there and wonder what to say or do, and realize that just being quiet is okay.

Yesterday I sat with a “client” like that in their 60’s, tears running down my cheeks freely as they haltingly let their story of grief and despair well up and overflow in their tears and naked anguished words.

But in that raw outpouring, for all of their sophistication and mature age, there emerged the childlike camaraderie between us of friends together by the river when truths bigger than our understanding slipped out into the world we shared of trust and emerging emotional truth.

So in conclusion I’ll say that it feels strangely paradoxical that I’d experience such a young inner feeling of tenderhearted kindness when with another’s emotional suffering after all these years of witnessing and opening myself up to the often horrific outpourings of a great many people’s experiences of their abuse, even sustained torture. Their abject inescapable terror, unfathomable grief and loss, heartbreaking betrayal, suicidal hopelessness, murderous rage — all of that plus being with both grown people and innocent boys and girls while hearing of them being stabbed, shot and beaten, of them wanting to show me their ragged scars and me seeing those scars, of being told of them being victims of incest and rape, addictions to every single possible drug. All of that plus hearing of the soul-killing lost years of people trapped in the psychiatric system where their very identity was stripped from them and replaced with a label and an endless supply of emotion-numbing drugs.

It seems paradoxical to me that I haven’t retreated into a world-weary despair and the isolation of emotional burnout.

How can the shy and gentle childlike kindness deep in our souls survive in any of us, I often wonder?

But I see in myself and others that it does survive, and possibly can live alongside the awareness of the tangible heart of darkness horrors that often traumatize our lives.

It also seems there is a growing darkness of the human spirit moving in the world. But in truth there is a growing power of merciful love on the move too.

I’ll meet you by the riverside, my friend.


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.


  1. Dr. Cornwall, Your lack of hubris combined with your apparent humility regarding the fingerprint-like uniqueness of the human experience is startling in it’s rarity.
    As an 11-year veteran of the industry’s psychotropic gladiator-school, I self-rescued and received an equally rare vacated bipolar 1 diagnosis and withdrawn SMI certification for my trouble; a 20-minute “lifelong” diagnosis nullified by an additional, perilous 2.5 year tightrope out the door.

    You represent a mythic, idyllic presentation of the perfect response to emotional expressions that compassionately challenges the APA’s influence on the “…American culture (that) has made almost any deviation from a continual smiley face into a psychopathology…”. (Leonard Sax)

    Good to know your engaged in this noble evolution.
    One of my biggest fears, after escaping-with the paperwork-was waiting to see if bitterness would be part of my embedded ‘make-up’. I feared the idea of a lifetime of bitterness. After 3 years of patience with my brain and body, I was delighted to find it wasn’t. To my surprise, I’m 2.0.

    Appropriate outrage, melancholy mourning for the losses, and a massive distrust of anyone connected with the system will be with me like a tattoo. Yet I find I can trust again, but oh-so-cautiously, and as of now, only from great distances, where I’m safe if I’m wrong.

  2. Dr. Cornwall, There are many opinions about the existential evils of the standards and practices of the psychiatric industry…
    I was part of a business-like ‘quid pro quo’ that involved them immediately jettisoning their own fundamental precepts…if I would just go away quietly…….

    After achieving safe exit from the industry, I twice emailed the APA to engage with the ‘phenomena’ of somehow having their ambassadors rescind a “lifelong” diagnosis ONLY when I presented an IMPLIED cost and liability disruption to their status quo…were they not men and women of good faith, science, and principles?

    As my 2-year journey out plodded along (guided titration, withdrawal), the words “mistaken’ or “false” never came up. I didn’t need to hear an acknowledgement at that time, as the quiet delicacy and danger of my ‘situation’ informed me not to rock the boat unnecessarily. It wasn’t germane to be described as ‘right’, my priority was to get safe and get out.

    But did THEY not believe in one of their own most fundamental and enslaving dictums? How could they as healers withdraw me off the drugs and not be jeopardizing my safety and their own future liability…if “lifelong” was true for bipolar 1?

    DTS/DTO anybody? The implication of ‘suiciding’ was their favorite tool to keep me on the drugs; it suddenly never came up again! That was easy.

    This was never about medicine, it was business…cut a deal and move on. And they did.

    The obvious conclusion was a ‘cost/benefit’ decision. Better to cut me loose than deal with the brief but messy, and possibly loud clamor surrounding the anaphylaxis they had caused…an alarming ‘side effect’ they couldn’t assign to bipolar 1…. and medically and legally super-ceded any psychiatric smoke-screen of mystical mumbo-jumbo that always waved off those entities.

    It exposes their willingness to sacrifice their own credibility and protect their inviolate status among medicine and the public vs.the welfare of a client that they insisted UNTIL THE DAY OF the anaphylaxis, was SERIOUSLY-mentally-ill for life.


    Not exactly an ethical medical assessment of the circumstances; more “give her what she wants, she’s old and poor, she’ll go away quietly and gratefully”.

    The punchline here is that after my second appropriate email to APA hierarchy offering dialogue regarding OUR extraordinary relationship of 96,360 hours of an ‘extreme state’ caused by their treatment, I received the another ‘brush-off’ form letter but THIS time they added…wait for it…”If you are experiencing a medical crisis, please call 911 emergency services”.
    I fell off the sofa laughing, scaring the dog. It’s never THEM, it’s always YOU…like little children or addicts.

    Their lack of insight, humility, and sense of irony is disappointing from the experts on behavioral health….
    and no sense of humor either!

    But it certainly exposes their willingness to quickly abandon their own claimed ‘science’ supported absolutes, justifying all that damage and suffering…and make a deal ‘under the table’ resulting in any possible irritant or threat to Just. Go. Away.

    Their special relationship with the judiciary has taught them to ‘plea deal’ a “lifelong” medical diagnosis vis a’ vis their own legal exposure and ultimate goals…maintaining their death grip on clients.

  3. Really lovely, heartfelt piece, Michael. Thank you for sharing.

    Paradox sure makes life interesting! Where there is darkness, there is also light. The paradox here is that it is ALL light, because without the dark, we wouldn’t know the light. If darkness is growing, you can bet the light is a few steps ahead and will show itself at the most divinely timed moments. My faith is unshakable here, and of course, I make it a point to see the light on everything, it’s always there.

    I think shadow/light integration is the key here, to ground light to Earth. Then we can create and manifest from that light energy which we all carry somewhere inside of us and to which we can all connect if we are focused on that intention, rather than to continue to create and manifest from our inner darkness, which is how we get caught up in these endless loops with no change, manifesting the same conflicts and issues over and over and over again. I believe we want to ascend that loopiness for new creation. Ascending paradox is a big part of that shift, I believe, to higher states of consciousness, while grounded in our human bodies. Great expansion there, lots of newness to be explored and from which to manifest.

    Allowing ourselves to be fully human, light and shadow, with no judgment or fear about that, would change the world considerably, imo. Way more light in that scenario, not to mention one of my favorite energies: permission! Then, we are free.

  4. Thanks Michael, for this fascinating, honest and deep exploration of what it means to sit with others experiencing deep, extreme states. The places where there are no words, because healing is the imperative and we must touch, soul to soul.

    My father and younger brother both suffered with paranoid schizophrenia. Both highly medicated: my dad had ECT and medication (mid 70s), my brother injections and weekly outreach meetings: mid 2000’s – his team were fantastic though, I met them at the psych. ward where he had himself admitted, twice and then at his funeral. Later on, I descended into what mental health ‘professionals’ would call psychosis when some of my childhood trauma repeated itself in my own family.

    But, I saw the ghosts, visions and prophetic dreams as friends, that was the difference. I have an open and deep spirituality and practice, which is where I differed to my birth family. And in 2014, after 3 years of searching, I found Open Dialogue and was lucky enough to be one of the first treated via “Dialogue First” the non-crisis pathway in the UK – and it was free! I’m grateful that I instinctively distrusted the mental health profession, as far too many lack the courage to explore and be with the soul, which you and I and all patients who somehow make it through, know all about.

    We’re the wise ones! Keep on with your holy and much needed work. Childhood joy and peace is our natural state when all is said and done. Our toxic institutions (all kinds) don’t want us peaceful though: we’re much wiser and much tougher to manipulate and control. Namaste. xxx

  5. I am in complete agreement with your way of being and have practiced it for many years. My question is the next steps, after the listening and holding space and witnessing the suffering for weeks, months, even years. I have a few “friends” who revisit repetitive compulsive thought habits and patterns of negative emotions and thoughts leading to misery. Is there a time for challenging these patterns? What have you learned about assisting people who are years down the road from their extreme states yet recreate them in their imagination? I was reading a research article about the necessity of bringing closure to a memory; that when people hear the rest of a tragic story (in research) their outcome is better. Any thoughts?
    Thank you, Cathy

  6. Thank you Michael. Your description of individuals experiencing psychosis being calmed and healed, simply through loving communication is very moving to me. I’m afraid this has not been my experience.

    I am a mother of a son with a schizophrenia diagnosis who has been hospitalized seven times. During the most acute phases of his illness I also believe he experienced a very dark, energetic attachment. He is, in his true nature, a very powerful healer himself… a very light and beautiful soul, and in a way I believe this increased his vulnerability.

    He had an uncle with the same diagnosis, and has a bipolar cousin. When I first married his father, their family doctors – who were European, holistic homeopaths) came to me privately and said you realize that if you have sons, they will be at high risk for mental health issues as the strongest genetic path is from uncle to nephew. And so it was with my eldest son.

    I congratulate you on your courageous work and I concur that the current psychiatric model of mental health care is profoundly askew and dangerous. Where I struggle with your comments is your suggestion that all a child needs is one parent who thinks they are the apple of their eye. I’m sure you realize how loaded such a statement seems to a parent who has lived through hell in an attempt to find a way to love their child enough to help them through unimaginable torment.

    Not only was my son the apple of my eye, a truly adored child, but he was raised in a deeply loving, close and caring family for his early years. It was in his adolescence that the emotional trauma of his grandfather caught up with him… a grandfather who was abusive to his father who then became unconsciously verbally abusive to my son. (Of course one can assume we could go back and back to great-grandfather and beyond.) In my “apple of my eye” state of loving my son absolutely I felt completely powerless in this dynamic. It ended my marriage, but even this, of course, did not resolve the pain.

    I myself am a healer who has worked with thousands of clients over a twenty year career, and I take a larger, karmic view of all human suffering. “Karmic” without the simplistic and mistaken reward and punishment implication, but rather karma as a way of seeing that we are all interconnected in our suffering and therefore our healing. I believe for example, that on a soul level I chose my birth mother who was a highly fearful and critical parent, because she offered me the contrast which impelled me toward the awakening of my own self love. I was far from being the apple of her eye, but I did not develop mental health issues. I became a prolific writer and healer instead. And I was blessed to have my father’s unconditional love, and a grandmother living in our home who provided the nurturing presence my mother lacked, so I’m sure this helped.

    But when you say that all that is needed is one parent who loves unconditionally, and a parent like myself reads this, do you realize how hurtful and unhelpful this assessment is? I have given up most of a decade of my life doing everything in my power to help my son. His care has left me financially bankrupt, physically and emotionally ill and exhausted, and denied me full relationships with my other children, with a partner, with my work and my own dreams.

    Part of the grave challenge in my son’s case is the condition they call anosognosia.. his lack of insight into his situation. At no time has my son ever been able to see that he is ill, troubled or needs healing and treatment. His view is that the problem lives outside of him.. in entities, lion beings and gods, insects, the police, the government, his father, me, an innocent teenager walking past him on the street whom he chooses to verbally attack, whomever he chooses to project upon in the moment. It is all everyone else’s fault, and never his own choice. Do you have any idea of the depth of challenge this situation creates for a loving parent? And then to read someone as knowledgeable as yourself, suggesting that if only I loved him a bit more, if only I were there for him he would heal… I can only say it is the greatest of ironies that not only do I encounter no support or understanding from the medical community, from my extended family, from my friends and neighbours, but also someone like yourself seems ready to blame me too.

    Your descriptions of the light around a loving caregiver who simply has to put an arm around the shoulder of an individual and hold them while they cry.. do you have any idea how often I have wished I had such an opportunity? My son almost never cries, in fact, this young man who was once the kindest, most compassionate and beautiful soul I knew, now seems to have a heart of ice. He almost never cries or expresses, and fiercely resists any of my attempts to encourage him to speak of his trauma. I have been here for him for years, but much of that time he has spent being abusive to me, breaking things, destroying my work and my business and getting us evicted from our home. And yet, believe it or not, still he remains the apple of my eye.

    Rather than leap to such a superficial assessment, what if you were to consider the karmic dynamic of these families. For example, in my son’s family, there is no point in looking at his situation without looking at how his father became abusive of him in his teens, and there is no point in looking at his father without looking at his father’s father. What happened to him to shut him down? To corner him so deeply that he projected his rage at his son? And all the fathers and fathers before him?

    Personally I cannot agree that the “toxic social, economic and stratified matrix of the alienating and unjust social Darwinism surrounding us all” is a sufficient description of the problem. I think we need to take a much wider view which recognizes that we are spiritual beings, and our dualistic universe is exactly how we learn to expand into consciousness. But that is a larger question for another day.

    What I would like to ask is, what guidance do you have for a parent whose own life has been stolen away? You could go home at the end of your workday. What about those of us who cannot, who live out our lives without any tangible support because there is no understanding of what we are dealing with, every moment of every day? Do you know that one neuroscientist/Ayurvedic doctor told us that in India, people like my son are taken to a temple and chained to the pillars on the temple grounds. They are fed and cared for by the temple priests.. left there for the rest of their lives because the families cannot cope anymore. That one, very ill person, would destroy an entire family, and so for the greater good of all, they were sacrificed, given to the gods.

    At one point I formed an online support group. I noticed that in the Facebook group Shades of Awakening, there were a number of mothers of sons, similar in age and situation to my own. We didn’t last long. Most of the women were too exhausted, too heartbroken, too financially destroyed, too guilt-ridden to be able to do anything for themselves, including show up for support meetings. I got to know some of them a little and what struck me that each one of them had what I call a “care-taking” pattern… meaning each of them would give away their own lives, their own needs, to save a loved one. Most of them were hundreds of thousands of dollars in debt, living in misery, their marriages broken, their personal happiness no longer even a remote possibility, watching as their other children ended up with eating disorders and depression as a result of the sibling with extreme states. When I asked one mother if there was anything she could do to help herself, take a break, get some rest, she said all she could think of was keeping her son out of an orange jumpsuit. That if she was not constantly vigilant, that would be where he would end up. I suspect she was correct, for this is exactly what happens in the West when families are overwhelmed, and let go.

    I continue to look for writings, teachings, insight of any kind into my situation, that does not come with blame or superficial assumptions about what I should do. I have stopped telling people, or even asking for their thoughts, as there is no one, other than someone who has lived this experience, that really understands. To them the stigma of the the horrific loss of my son’s true nature, his innocence and his light, has to be my fault in some way. And what you have written here does not help that terrible alienation we families live with every day. With your words you are perpetuating the suffering of parents like me. In fact, I would go so far as to say that my lonely, fierce love for my son may in fact be a part of the problem. I have become so entwined with his life, with his care, that it is not a healthy dynamic. He needs masculine acceptance and love.. and a community willing to hold him so that I can have a life too. He needs friends, a job, a partner. All the usual things that he probably will never have.

    I posted your article on my Facebook timeline because I agree thoroughly about your description of the mental health care system. But may I suggest that you tread a bit more lightly in your readiness to suggest that the kind of tragedy that my son and I live every day, could simply be cured if I loved him a little more.

    What would be profoundly helpful would be if you would write about the question of anosognosia. I am familiar with the work of Dr. Xavier Amador, but it doesn’t go far enough for me. Again, the suggestion is that as a family member our role is simply to accept everything our loved one says or does. To earn their trust. He does not address how to handle this when the loved one is frequently aggressive, abusive or toxic in their behaviour. For example when my son escalates, his energy field is so big he makes my dogs vomit spontaneously. Am I asked to passively accept the terrible things he says to me, day after day, year after year, in the hopes that one day he may trust me enough to consider engaging in some kind of treatment? I very much doubt it, or it would have happened by now. Dr. Amador doesn’t discuss this, because he too didn’t live with his affected loved one. He was not a mother giving up her life in the hopes of some kind of salvation for the apple of her eye.

    Ultimately I wish for an over-arching wisdom to come to all who suffer in this way. For the mental health care-givers to see that there is no one in this dynamic who does not deserve loving support. And that it is very easy to judge what you have not lived. There but for the grace of god, go all of us.

      • Stephen my son’s childhood was very loving and peaceful. It was during his adolescence that many expressions of the wounded masculine came into his life, and a big part of this was the breakdown of his relationship with his father and the end of our marriage. As a high sensitive, he was a sheep amongst wolves. He had a group of friends, all lovely souls and yet each one struggling, vulnerable in different ways. When there was an altercation, he was the one who went back to help, and would end up getting caught and taking the blame. During that time there were several traumas, including being attacked by a gang on a subway platform and being beaten and tortured by the police when he was fifteen. He then fell into a relationship with another wounded bird, a young woman with addiction issues and that affected him as well. But he had actually walked away from all of it and was healing, fasting, juicing, training in martial arts, studying holistic healing and consciousness voraciously (he is a powerful healer) and was engaged in a deep meditation practice when he had a Kundalini experience which triggered his first episode of paranoia and then intense psychosis.

  7. adikanda, I’m so sorry for all that has happened to you, your son and your family. To a slight degree, similar things have happened to me, with my son (and our only child.) His uncle Eric (my younger brother) suffered from paranoid schizophrenia too, and became a drug addict at 14 (cannabis) then moving onto heroin.

    What I’ve observed is this: my younger brother was the most beautiful of the 3 of us, and was born at a time when my father was experiencing professional grief (the De Havilland Comet – the world’s first jetliner – on which he worked as an engineer) crashed three times, and had to be withdrawn from service. This was the pinnacle of my dad’s career; my mother also suffered from postnatal depression after Eric was born, and then, 2 years later, she was diagnosed with cancer. My father (a widower when he met mum) couldn’t see this as unfortunate life events, rather he looked to BLAME someone for these events, and Eric, as the most vulnerable became the SCAPEGOAT. Eric was a very happy child, full of light, and I think my father couldn’t stand it – he was a ‘dark’ man, who would spill over with anger at the slightest thing. All 3 of us walked on eggshells in our early childhood and my mother tried to run away several times (I learnt from my two half-sisters who came home from boarding school, and who were also very relieved to return there – the family dysfunction was very tough to see.)

    Eric never escaped that role – I stood up to my father and blamed him for his aggressive and cruel behaviour and was told to “mind your business, you bossy child.” So, I became the observer/witness to it all. We were a really unhappy family, it must be said.

    Some of these events repeated themselves in my own family. I chose a husband similar to my father and my son was severely scapegoated for a while, about events over which he certainly didn’t cause (my husband’s escalating alcoholism when his father was dying from terminal cancer.) It was devastating – and Eric was then in the final years of his life (by then a registered methadone user, no longer working after my mother died) and he sectioned himself twice in that period.

    Eric took his life on Good Friday, 2009: an appropriate day for a scapegoat. (He did have several years of happiness with an older man – Eric was gay – who acted as the father Eric had never had. It was great to see him happy and out and about, enjoying himself being fully accepted for who he was – finally!)

    All of this was very tough for our lovely son to witness. He’s had many setbacks in his young life.

    So, the karmic theme I’ve seen emerge is Prodigal Sons. My father was a prodigal son (apple of my grandmother’s eye), my husband similarly. They have an unspoken belief that everything must go well for them – a huge sense of entitlement. When things don’t, they get very angry and look to blame. I see this in all institutions, by the way, which is one of the reasons we’re not evolving spiritually. We’re stuck in the continuous aggressor/scapegoat cycle, largely because the AGGRESSOR refuses to look at his/her darkness. and do the work required to change their mindset and thus the energy.

    I’m much more assertive at home these days, and many things have healed. This is because of the Open Dialogue therapy and my courage of immersing myself in the deep pain of dysfunctional family narratives. My husband and son now take more responsibility for their behaviour, because they’ve seen the damage it caused me psychically and emotionally. Progress, not perfection. (And my son and I speak of many spiritual things together, and the need not to repeat the drama – we’ve seen the terrible things repetition causes.)

    I don’t know enough about people doing work in this area, but what I am 100% confident in is that the Scapegoat is a universal symbol and is there in all tribes. The tribes form around an agreed view on who the scapegoat is (whether an individual, tribe, religion etc.) and then marshall to remove or destroy them. Look at the Rohingya Muslims, for instance. There is a bloodlust for destruction rather than the slower, deeper creation of changing our beliefs and becoming TOTALLY responsible for the ways we think, speak and live, which is how more evolved souls live. The Earth was created for all of us to walk on, enjoy and live peacefully with one another, is my belief. Sharing and Caring…..

    I hope that my words may give some hope, adikanda. Namaste. xxx

    • Thank you so much for this sharing Annette.. you offer such a clear and moving picture. This phrase “Eric was a very happy child, full of light, and I think my father couldn’t stand it – he was a ‘dark’ man, who would spill over with anger at the slightest thing” is very potent to me.. I have seen this play out in both my own family and my ex-husband’s. I think of it as an expression of the wounded masculine.

      In my work as a healer I see this dynamic play out in what I think of as karmic patterning, where the vulnerable one, the “beautiful” one as you describe your brother, seems to energetically call aggression to them, as if they are the one to digest so much of the imbalance all around. I only wish my son would be receptive to something like Open Dialogue – I think it could be a powerful support. Unfortunately due to the anosognosia he stubbornly resists any and all treatment.

      Thank you again for your kind words.

  8. Michael, I appreciate your writing but ah not quite what I have been hoping for from professionals.
    You and the others choose to stay in the system and I don’t know if you shared your own experience with altered states or not. My guess is you did not? Not clear and as the system was getting more restrictive and more Pharma based what did you do? When folks reported abuse did you do anything to change the system or really could you?
    Did you contact the county or state officials? Did you ever try to find peers that really were like you in past experience?
    My sense of things before my forced time in system was folks who divulged their past were stigmatized not maybe in from but from behind.
    I am looking to move and going through stuff. I am going to share a letter I found- an apology from a high school friend. Unasked for but decent.
    This is 15 year old male teen who lived in a blue collar neighborhood, father dead and life not that easy. I was more upscale but very learning disabled and on the fringe of life- part but not parcel.
    This is the next step.
    I know I’ve been a real pain in the…..neck. And I know I have done some stupid things. All I can say is that I’m really sorry. I hope you will forgive me and still think of me as your friend.
    4 sentences. It does not take much.
    We have lost the art of this and fear rules the day in terms of any type of restorative justice. Responsibility even when ah 39% or 89% not my fault.
    Georgetown University is muddied and muddy but it’s out there and the river is running through it’s slave ownership history.
    My one relative ran a part of a medical research tri- part community for ALL involved. She dealt with families and she was bowled over by their desperation to find ANYTHING that would help. She was amazed with the patients. She liked and admired some of the professional staff, others not so much. But she gave all equal footing.
    This is what we survivors need equal footing to be heard and the freedom not to live in fear so that we can speak.

  9. Thank you for this moving piece and for your years of insightful, inspiring work Dr. Cornwall. Many people benefited from you choosing to stay in the system and be there for them. The world definitely seems to be growing darker but thankfully yourself and other healers with beautiful spirits and hearts of kindness and goodness still shine brightly.

  10. Being involved in political activism makes the difference, not therapists and recovery programs.

    People have to learn from comrades, shoulder to shoulder on the barricades, not in treatment and recovery programs.

    We should not be allowing our government to license psychotherapists or psychiatrists.

  11. Thanks you. You had a much different experience than I had. I supervised a social work student who my own supervisor refused to work with because she was out with her status.
    Living in an area with many medical and academic institutions the peer movement was almost nonexistent. The one state peer group disbanded.
    I guess in my journey I am still caught in the abuse that occurred and lack of any ongoing peer contact that fits for me. Everything is NAMI based everything.

  12. Thank you for this touching article. I fear there is a long way to go before people experiencing extreme states and psychological distress will be treated with such kindness.
    Does ‘extreme state’ refer only to people who are experiencing psychosis or can it also include people who are suffering immense sadness or overwhelming anxiety? I sometimes feel lost when I experience feelings like these because I do not want to turn to medicine (I do not believe in the biological model) and I do not particularly want to talk to strangers with titles such as ‘therapist’ or counsellor. This feeling of being lost only serves to fuel my negative feelings.
    Another question regarding trauma. What constitutes trauma? Is any form of prolonged negative childhood experience considered a trauma with the potential to bring about unpleasant mental states?

    • I think “trauma” can only realistically be defined by the person reporting the experience. Trying to set some kind of standard only gets us confused. Some people are sexually molested by a family member, yet are believed when they tell their parent or loved one and are protected, and some of those people reportedly have relatively little long-term impact from the experience, while others find it horribly traumatizing. Some folks are yelled at by a parent or teacher or left on their own very young and feel frightened enough that it ends up being a lifelong issue for them. I think you get to decide how traumatic an incident that you experience is for you. Anything else is just authoritarian invalidation of your experience.

  13. Political activism is the antidote to Psychiatry, Psychotherapy, Recovery, and Salvation.

    I’m trying to look into Eve Ensler now. She seems like someone who would not let a therapist turn her experience of injustice get turned into a self-improvement project.

  14. PD, Eve Ensler has just come out with new writing on trauma and recovery. One event had Glenn Close who did an anti stigma campaign on labeling but missed the mark. It was as a helpful family member not psych surivivor.
    Eve writes the apology she would have liked to hear from her father if he had seen the so called light of his parenting actions – which were really abusive in multiple ways.
    The discussion here as been lovely in terms of using a vocabulary that enables hard and painful dialogue.
    The parents especially mothers who are the ones to hold together everything with sometimes little or no community support and sometimes the support that is there takes along while sometimes to find one has been snookered and snickered.
    The group of support for multiples was more a money raiser than help. PTA a true grapevine – one has to pretend everything is just perfect, just perfect and then alone who do you blame? And if there are other issues? And if one really talks to other parents – yes we have at one time or another crossed the red line. And as mothers we bear the responsibility of seeing fathers verbally or physically berate our sons or I guess daughters and we become frozen. Trauma over and under and between and inside and below and above.
    For the mother with the son- I apologize I can’t recall and get your name.
    Kabul Gibran – are Children are not ours- arrows beyond us.
    Thanks to all for the words.

  15. Michael is there someway you can be cloned? A little joke but seriously how do people come to that place where they can listen to people in distress and pain, we seem so afraid, as if the pain of others might draw our suffering to the surface where it will be exposed and permanent.

  16. Dear Dr. Cornwall,

    How did you survive the burnout and despair? Can it be as simple as your belief in the existence of the light, and of merciful love? I am on the path of becoming a therapist, yet my fears of falling into despair are growing. I feel as though I must have some sense of God or spirituality to hold onto, or that I have to have the heart of jesus and the mind of a warrior in order to deal with all the pain. Any advice on how to sustain yourself throughout the years would be very meaningful. Thank you.