Exile: My Cure for Psychosis

The minute I first set foot on European soil in June 1968 I felt better.  I felt better about myself, about life and about the world.  I was overcome with the joyful certainty that American psychiatrists would never be able to find me on the other side of the Atlantic Ocean.  They had tortured me for four years, between the ages of sixteen and twenty, first because they suffered under the delusion that my homosexuality was a mental illness, and then by their certainty that my schizophrenia, which they had created, was incurable.

When I began my exile in Europe, I was twenty-two years old and all that I had as resources were my degree from Harvard and my knowledge of the French, German and Italian languages.  I was determined to live my life on my own terms, without once caring about what other people might think of me.  I would dedicate my life to what I enjoyed, namely: languages, books, travels and love affairs.  American psychiatrists, my parents, professors, and clergymen would simply have no idea of how much I was delighting in life by doing all kinds of things of which they would disapprove.

Thus began a happy life in exile.  During the past fifty-seven years I have done splendidly without once consulting a psychiatrist or taking psychiatric medicine.  The purpose of the present article is to raise the question of to what extent the mere fact of living in exile can help one recover from psychosis.  At age eighteen I was incarcerated in the McLean Asylum for the Insane, as it was originally called, and given the diagnosis of an acute paranoid schizophrenic psychosis with an extremely bleak prognosis since psychiatrists were convinced that schizophrenia is incurable.

But I possessed a secret weapon that my psychiatrists knew nothing about.  I was certain that I had been driven crazy by my first psychiatrist who attempted to change my sexual orientation.  I refused to share this information with my psychiatrists at McLean since I was certain that they would not believe me.

If I am correct in saying that exile can cure someone of schizophrenia, then I have proven that psychiatrists are wrong in claiming that mental illness results from a chemical imbalance in the brain.  I know very well that my psychosis was a consequence of numerous traumas that had nothing to do with the chemicals in my brain.  Every time I went to see my first psychiatrist during a period of two years to be told time and again that I had the wrong sexual orientation was a traumatic experience for me.  Of course the worst trauma of all was being incarcerated against my will so as to be subjected to fifteen months of psychiatric cruelty and incompetence.

What is at stake here with this discussion is the billion-dollar business that the pharmaceutical companies make with their unproven myth that mental illness results from a chemical imbalance in the brain that can only be corrected by taking antipsychotic drugs.  This myth shows the most unethical aspects of advanced capitalism by which the richest and strongest people exploit the poorest and the most vulnerable.  For no one is more vulnerable than schizophrenics.  The number of schizophrenics who make a public confession of their illness is extremely limited, since the consequences can be disastrous.  Someone needs to break the ice, so to speak, and I am willing to do so.

My discussion of the advantages of exile for people recovering from psychosis will have two parts.  The first one will deal with the universal benefits of exile for people of all nationalities.  The second one will concern the healing benefits that are specific for Americans who choose to go into exile.

A person living in exile is liberated from all concerns about his reputation, for he has no reputation.  He is by nature a stranger and thus profits from a freedom that he would never have at home.  Being a foreigner gave me a sense of real security since I told myself that if I ever said anything really crazy, people would just assume that I had not learnt their language correctly.  Likewise, if I did anything insane, people would tend to attribute my weird behaviour to my status of being a foreigner.  They would simply assume that my peculiar actions were typical of the country I came from.

Of course my best friends in Europe knew all about my history of schizophrenia and my homosexuality, but they did not feel the least bit threatened by me.  I told most Europeans who asked me why I had left the States that it was because I was opposed to the Vietnam War, which, of course, was true to a certain extent.

I sincerely believe that many cases of mental illness are caused by traumas involving one’s family.  The best way to recover from these traumas is to distance oneself as much as possible from the people who created the traumas, i.e. one’s family.  The French writer Margaret Yourcenar said so wisely: “Où est-on mieux que dans sa famille?  N’importe où.”  “Where is one better off than with one’s family?  Anywhere else.”

In the epic Polish novel With Fire and Sword, Henryk Sienkiewicz shows that nineteenth century Polish peasants had a better understanding of the etiology of mental illnesses than do today’s psychiatrists: “Those are crazy people, who wander about in the woods, and scream.  They have lost their reason, through the sight of the horrors that have occurred.”  These people are crazy due to the horrors, the traumas, that they have seen, proving that psychosis has nothing to do with a chemical imbalance in the brain.

The greatest advantage of living in exile for anyone recovering from psychosis is that one is totally free to do whatever one wants.  There are no psychiatrists or clergymen or professors or relatives who claim to know better what is right and what is wrong.  It is precisely the severe limitation on personal decision making required by undergoing psychiatric treatment that prevents the patient from becoming a totally autonomous free agent.  Psychiatry tends to infantilize the patient.  While living in exile and without psychiatrists, formerly psychotic people have much greater likelihood to achieve mature, healthy independence.

During a schizophrenic psychosis, one feels like a foreigner in one’s own country.  The schizophrenic does not relate to the environment surrounding him.  He does not share the ideas, the myths, the values or the dreams of society.  For me, this meant that I had no desire to have a million dollars or to be famous.  A fundamental American myth claims that becoming rich and famous is a normal ambition and that anything that contradicts it is insane.  Nor did I want the United States military to defeat the Vietnamese, which made me a traitor.  Feeling like a foreigner in one’s own country means that there is no reality for the schizophrenic, who refuses to accept the dominant understanding of what constitutes reality.  Psychiatrists could accuse us of having lost contact with reality, as though it were our fault, when indeed the reality that we were rejecting is now accepted by everybody as being detrimental and criminal.  Today, no one thinks that homosexuals should be cured of their sexual orientation with psychiatric conversion therapy, just as no one thinks that the world would be a better place if the United States had won its war against Vietnam.

When I started my exile, I told myself that I might be losing America, but that I was gaining the world.  I was what the Germans call “heimatlos und doch überall zu Hause,“ ”Without a homeland and yet everywhere at home.”  In 1974 I became a citizen of Ireland in the Irish embassy in Bonn and renounced my American citizenship.  I remember sometimes walking around the centre of Bonn, where I was teaching at the University, and overhearing the voices of American tourists.  I had been thinking in German, dreaming in German, speaking German, reading German, writing German and all of a sudden I would hear American voices.  I bristled.  Just the sound of Americans talking brought back memories of the traumas that I had suffered in the States.  Exile was a healing experience.

For the past forty-eight years I have had the immense privilege and great honour of living on the banks of the Saguenay River in Québec.  Québec undoubtedly has both the world’s most beautiful scenery and the world’s nicest people.

Exile is particularly beneficial for Americans who are recovering from psychosis.  Experts complain about the rapid increase in mental illness in America.  Robert Whitaker’s two books, Mad in America and Anatomy of an Epidemic, both document the startling rise of the number of Americans who request governmental assistance because of mental illness.  He shows how the proliferation of psychiatric medications accompanies rather than diminishes the mental illnesses that they are meant to treat.  Something has obviously gone seriously wrong in the United States.

I have told myself so often that if I had stayed in America instead of leaving it forever at the age of twenty-two, I would probably have spent my entire life going in and out of mental hospitals, being treated by numerous incompetent psychiatrists and taking antipsychotic medicine with its devastating side effects.  Whatever psychological fortitude is required to survive in the United States I simply do not possess.

What makes America the least propitious country that I know of in terms of achieving good mental health is quite simply the predominance of violence there.  America is a violent society and mentally ill people are simply not equipped to deal with so much violence.  The real scandal is that the American people have not only created this violence, but that they have consciously chosen to encourage violence through their laws and social customs.

The United States is one of the only countries on earth in which people are allowed to carry firearms in public.  The omnipresence of firearms explains both the high rate of homicides and the fact that America has the world’s highest suicide rate.  The following shows the homicide rates of the seven countries in which I have lived, along with the years that I lived there.  The rates refer to the number of people killed per 100,000 inhabitants in the year 2022.

• USA 6.38 (1946-1968)
• Ireland 0.87 (1968-1970)
• France 1.56 (1970-1971)
• Germany 0.82 (1971-1974)
• Poland 0.67 (1974-1975)
• Spain 0.61 (1975-1977)
• Canada 2.27 (1977-present)

In 2023, on average 118 Americans were killed by guns every day.

Here are the incarceration rates for the seven countries.  They refer to rates among l00,0000 inhabitants.  The statistics were updated in October 2024.

• USA: 541
• Ireland: 91
• France: 115
• Germany: 68
• Poland: 194
• Spain: 17
• Canada: 90

The following are the suicide rates for the seven countries, once again for a population of 100,000 inhabitants.  These statistics come from 2019.

• USA: 14.5
• Ireland: 8.9
• France: 9.7
• Germany: 8.3
• Poland: 9.3
• Spain: 5.3
• Canada 10.3

The statistics show that the United States is much more violent than the other six countries, whether in terms of homicide, incarceration or suicide.  Since mentally ill people are those who find it hardest to live in an atmosphere of violence, they are the ones who could benefit the most from leaving America.

Despite the grim picture that these statistics reveal about present-day American realities, American politicians continue to tell the electorate that the USA is the best country in world history, and everyone cheers.  This myth of American superiority goes back to the seventeenth century when Governor John Winthrop of Massachusetts declared that New England was destined to become “a model of Christian charity” for the rest of humanity.  This was the beginning of American exceptionalism, as it is called today.  It can be summarized by Madeleine Albright’s claim that America is the world’s “one indispensable nation.”  If America continues to spread its cultural influence around the world, we should expect other countries to see a rise in their homicide, incarceration and suicide rates.  All my European and Canadian friends worry about the proliferation of American violence around the world.  They cannot understand how the United States continues to claim superiority.

Someone recovering from a paranoid schizophrenic psychosis must find it extremely difficult to survive in a society where he can quite rationally fear that the person standing in front of him might have a pistol hidden in his pocket.  Yet the American people permit such dystopia by refusing to repeal their Second Amendment.  No politician dares to propose such a solution.  Americans prefer to wallow in their bloodthirstiness rather than to change their Constitution.  Donald Trump has advised Americans to take pistols to church with them in order to defend themselves against anyone who might start a shooting spree.  American schools are now being built in such a way as to reduce the number of children killed by gunmen.

The cult of violence and killing extends to the United States military establishment, which has killed somewhere between twelve and thirty million people in illegal wars since the end of the Second World War.  Russians justify their wars in Syria and Ukraine by saying that America set the example.  Israelis say that their treatment of Palestinians in Gaza is far better than the Americans’ treatment of Iraqis.

I believe that this omnipresence of violence is detrimental not just for paranoid schizophrenics but for people suffering from any kind of mental illness, including bipolar disorder, anxiety and depression.  It is very hard to become well while living in a society that is ill.  Exile is the best option.

But American violence is not limited to killing people at home and abroad.  It permeates all of American society.  Violence can be verbal.  Politicians are always saying that they are “fighting” for this or that, as though fighting were a normal way of living together.  The proliferation of swear words is an expression of verbal violence.  Every time an American says “fucking,” “shit” or “it sucks,” I feel that there is violence in the air.  The number of Americans who cannot make any comment about anything without using these words is staggering.

A few anecdotes from my hometown in New Hampshire will illustrate this point.  At our local hospital there is a sign that says “For the safety of our patients and employees, Memorial Hospital prohibits the carrying of weapons in our facility.”  Reading this sign provides a real culture shock for a European or Quebecker.  One mile north of the hospital there is a post office with a sign inside saying: “Please do not dispose of animal or human waste in the trash can or the recycle bins please take with you thank you.”  Apparently some Americans think that it is normal to leave their excrement inside the post office.

Three years ago I was taking my daily walk on a quiet road with expensive houses in the woods of New Hampshire.  I was walking on the left side of the road.  On the right side there was a woman in her thirties with a dog on a leash, walking in the same direction.  I immediately thought of Anton Chekhov’s story “The Lady with the Dog.”  There was no traffic.  I was walking slightly faster than the lady with the dog, so I eventually caught up with them.  When the dog realized that I was following them, he leapt at me, growled, bared his teeth and attempted to exterminate me.

Being a naïve European Quebecker, I was certain that the young lady was going to apologize with great embarrassment for her dog’s scandalous behaviour.  Instead, she barked at me: “You scared the shit out of me!”  I was so shocked that I could think of nothing to say other than: “I am not an American and so I am not used to being spoken to with such language.”  She replied, “Go walk somewhere else, you asshole.”  There I was, a seventy-five-year-old man walking in a village where my family has lived since 1850 being told by a young American woman that I had no right to be there.  I am simply psychologically unable to deal with such rudeness.

Thus I have come to the conclusion that Americans must find it hard to recover from a mental illness as long as they are surrounded by other Americans.  The violence, the vulgarity, the disrespectfulness, the rudeness, the hostility and the viciousness that have become so common in today’s America make it difficult to achieve real mental health while living there.  Try exile.