Kindling Our Inner Fire: A Residential Program Where Drug Tapering is the Norm

 Hello, my name is Robert Whitaker, and today I have the great pleasure of speaking with Beatrice Birch. She is the Founder and Director of Inner Fire, a residential program in rural Vermont, which, for me, is unique in one particular way. It provides support for tapering from medications, including antipsychotics, which is an essential aspect of the therapy.

The transcript below has been edited for length and clarity. Listen to the audio of the interview here.

Robert Whitaker: Welcome, Beatrice, to Mad In America Radio.

Beatrice Birch: Thank you very much, Robert.

Whitaker: Let’s start at the beginning. You’ve been doing this for 10 years, which is quite an accomplishment. Tell us why you started Inner Fire? 

Birch: Thank you. To be totally honest, I had no idea I was going to be doing something like this, but for about 35 to 40 years, I’ve been working as a Hauschka Artistic Therapist in Europe, and I was working at a rehab in the United States upon my return. A number of the residents realized that I was not really from the system, how I met them, and so they developed a trust in me.

After about three years of working there, a number of them came into the artistic therapy space, and one at a time looked me straight in the eyes and said, I hate being medicated. Is there a choice? In the places where I worked, the clinics I worked in Europe, we never medicated anybody. I could see the difference.

It was a totally different experience with artistic therapy. I shared what I could with them, and eventually they left this program, and within two years of their staggered departures, six of them had chosen suicide.

Whitaker: Six had chosen suicide? Out of how many people?

Birch: Over this period, there could have been 12 or so people, something like that, who had been at this rehab when they left.

When I heard of the first suicide, to be honest, I thought to myself, I’m out of this. This is too serious. I’ve never met this in my alternative practices in Europe. Then I realized innocence is bliss, and I’m not innocent. Why did all these people come to me and state the same thing? In my lingo, I would say this is a karmic moment? I can’t bury my head in the sand.

Whitaker: I want to go back to Europe just for a second. Where were you in Europe? Was there something, and I’m going to mispronounce it, anthroposophical philosophy that was part of your work?

Birch: Absolutely. I worked mostly in England, in the UK, in anthroposophical clinics.  People may be aware of the Waldorf Schools or biodynamic agriculture, anthroposophical medicine, but it’s a way of looking at the human being as having a body, a soul, and a spirit. I had worked out of this view of the human being for like 40-odd years. It’s remarkable because you really meet the whole person. We’re not just genes and hereditary forces. Actually, I see mental health as a reductionist term for soul health. We’re actually talking about the soul.

Whitaker: Going back to your experience in the UK, were you working with people who had diagnoses like schizophrenia or bipolar? Who were you working with there?

Birch: A whole spectrum. Many people with cancer, asthma, angina, and other physical conditions, but they are soul-rooted, but also with what we call mental health issues too.

Whitaker: You have this philosophy behind you. You have the experience of working in a rehab center where people were all medicated, and you saw the despair and the loss of life. What do you decide to do?

Birch: I realized with these suicides, I could not hide my head in the sand. I’m consciously choosing to take their suicides as their sacrifice and their wake-up call. I made an inner promise, you haven’t died in vain. I don’t know how the heck I’m going to do this, but I know there’s an alternative to these psychotropic meds. I’ll find my colleagues, and we’ll offer what we can. We’re simply offering a choice. We’re not telling anyone to come off. Then it was a very strange experience because once I said yes, it’s like I had so much support behind me.

Whitaker: In some ways, Beatrice, I see Inner Fire as a possible model project that others could follow. You got donations to buy a farmstead, right?  Tell us about the farmstead you bought and how you and Tom first lived in the house, and how you got it going that way.

Birch: Tom Kavet is my husband. As he will readily admit, he had no idea what he was getting into when we married. But it was just that I had to do Inner Fire. He would support that. He’s the economist for the Vermont State Legislature. His world is very different from my world,  but he was very open to supporting it. The stories that he would hear and the situations that he would witness, he just grew more and more into it, seeing how crucial it is that we offer a choice.

Whitaker: Let’s talk about some concrete numbers again, because I think part of this story is a model for others, possibly. For example, you bought a farmstead, an abandoned farmstead. How many acres is it? If you don’t mind, tell us how much it costs.

Birch: It cost just over $500,000, which is remarkable. It’s 43 acres. The beautiful thing about it is that it had been worth up into a million or so, but the person who was wanting to sell it had been having a hard time selling it. When she heard about what we wanted to do, she brought it down to a level that we could then gather the money to buy it. She just totally believed in what we were going to do and made it possible for us to do this.

Whitaker: When you started, you were all in the house. You and Tom were in one wing. How many rooms for seekers did you have?

Birch: No, actually, Bob, we had to rent two other buildings because in the main farmhouse, there wasn’t much space to sleep. I had to raise, and I’ve never raised money in my life before, but I raised over a million dollars so that we could build the east wing of the Inner Fire Home.

Whitaker: When did you get the dormitory built? 

Birch: We finished it at the beginning of 2019. We have eight rooms there. When we can get the west wing built, we’ll have 12. But we don’t want to be any bigger. It’s got to stay small. The work is so intense.

Whitaker: Are you usually full?

Birch: We seem to average somewhere around six or so. Sometimes in our first year, we had like nine. It’s just as well, because the work is so intense. There’s no way we could be that much bigger. Also, to be honest, sometimes it’s hard to find guides, our staff, who will go through the eye of the needle with these people in their tapering process. As one father pointed out one day to me, he says, I don’t think anyone has done what you’ve done. I thought, well, what do you mean by that? He said, I don’t think anyone has actually lived with people for 10 years.

I thought to myself, well, maybe not, because mostly they’re psychiatrists who don’t know what happens in the tapering process. But yeah, Tom and I lived in two little rooms, and  had a tiny kitchen one person could get in at a time. Finally, we have our own spot, which is great. But that was for nine years.

Whitaker: For nine years, I knew it had been a long time. Tell us about who the patients are that come to you, with what type of difficulties, diagnoses.

Birch: We pretty much consider almost anybody unless they’ve had a lot of violence in their history. Then we’re not big enough for that. We don’t have enough staff for that. We’re also not a locked facility.

They can have all different diagnoses. To be honest, I don’t even pay attention to their diagnoses. I want to know who you are and what your aims are. They can be in the [tapering program] but the tapering is very slow. If somebody says I’m on my Benzos and I want to cold turkey tomorrow, it’s like we’re the wrong place for you. We won’t do that. You have to stay engaged in the program. What I realized over these 10 years is that if we didn’t have the program, I don’t think I would do this.

Whitaker: You’re talking about how you wouldn’t do tapering unless you had a program for it.

Birch:  I think one cannot underestimate how important it is to stay grounded as you’re tapering, because as one person described to me, when you’re coming off this blanket of lithium, suddenly all the colors are brighter. The sounds are sharper, and you can easily become overwhelmed. Then you slip up into your head, and you’re off. We really have to work preventively.

Whitaker: It’s the same with antipsychotics, isn’t it?

Birch: Absolutely.

Whitaker: But you will help people taper from antipsychotics, too.

Birch: We do. You know, it’s not unusual to have somebody come in on eight different psychotropic meds. Three of them are maybe antidepressants.

Whitaker: Is it fair to say that many of your clients, your seekers, have failed within the traditional psychiatric system? 

Birch: That term failing is a bit of a funny thing for me, but no, it doesn’t work. They’re desperate, and they’re suicidal. We had one person not so long ago who was terribly suicidal before coming to us, and told me, because you’re at Inner Fire for three weeks before you begin to taper, you get into the rhythm. That’s what the three day visit is about. You know what the program is, and either you say yes to the program or you’ll say no.

With the program, you’re up at 6:15, you have a schedule for the whole day. Many of the people have been up all night watching porn or not able to sleep, and so the first few days it’s like, whoa, I don’t know if I can really do this. But they get into it.

One little example. Once we had a seeker whose name was Peter, and he had been haunted by voices for years and years and years. He came to me one day, and he said, Beatrice, I’ve just been splitting wood for two and a half hours. It’s the first time in years I haven’t heard voices. It’s like, Peter, you can’t hear voices when you’re splitting wood because you have to be grounded.

Whitaker: You have to be paying attention to what you’re doing.

Birch: Exactly. Getting physically into your body is crucial. That’s why someone tipping into mania will jump rope. You have all this energy, but you’ve got to be focused. You have to be in your body. There are many things like that we work with.

Whitaker: You said there’s a year commitment because you basically think it takes this time to really get grounded and healed, correct? That’s why it’s not a month, not two months, why — why the year?

Birch: At this other rehab where I worked, I saw people coming and going all the time. But as a therapist, I didn’t see anyone getting well. I thought this is a good business model, but you’re not helping anybody. I just made this inner commitment. It’s got to be a year because step one is getting off the medication. Step two is dealing with the issues that led you to seek support in the first place.

Whitaker: That’s a great way to put it.

Birch: It’s hard enough to get off the meds. Then you’ve got to deal with maybe abuse that you haven’t been able to talk about or all sorts of other things. That’s the soul work. But we do it all the time. It’s not that you do one and then you do the other, but we have the different therapies in the afternoon.

Whitaker: I’m going to ask you about the program and what  it’s like, but before we do, I know what a lot of listeners are asking:  how much does it cost to be there for a year? 

Birch: It costs $237,000. Now, for me, that’s the hardest thing of all about the program. But I would say about two-thirds of the people have come here with some financial aid. It’s all fundraising. You’ve got to pay our guides properly, but nobody gets rich working at Inner Fire. You work at Inner Fire because you believe in what we’re doing. I’ve been trying to get state funding, but they’re not interested.

Whitaker: No insurance?

Birch: We had one mother who, she is very tenacious, and she got told she had to pay first, but she did get reimbursed for the whole year. She also told us how we have to talk about our work so that the computer will recognize it as a program. We’ve learned the ropes a bit. If you’re very tenacious, you might be able to get refunded.

Whitaker:  I’m not surprised it costs that much. Think if you were in a hospital for a year. But it is a sign of a systemic failure that we can’t offer this to people with healthcare, with insurance.

Birch: Absolutely.

Whitaker: Describe for everyone, what the physical place is like.  The views, the woods, the river, give a sense of what it’s like to be there.

Birch: Well, it’s this combination. The terrain is very interesting because the farmhouse is in the valley. Then you have to walk up a steep hill through blueberry bushes and all that to where you get a vista. That’s where the east wing of the Inner Fire Home is. But we have a beautiful brook that we walk along every morning. We go for a walk with our 12 goats and kids, who keep us all in laughter as they’re romping and playing.

It’s this wonderful combination, no streetlights, so you see the stars at night, and the seekers learn to walk up to the east wing, maybe without even nightlights, that’s up to you. But just to trust the darkness and the beauty. We’re in a valley, Brookline is a valley, and so you’ve got the hillsides and the mountains, and the seasons are beautiful. Nature feeds our souls. It’s all about feeding the soul, helping it to breathe.

Whitaker: I’ve been there multiple times, and I can attest it is a beautiful place, and it does feed the soul being there. One of the funny things I can also attest to is that the mobile service isn’t so good there.

Birch: At Inner Fire, you don’t have your cell phone. You don’t have your computer. At this other rehab in the evenings, I would see all their residents all on their computers, not connecting with each other. I just felt that for one year, you can do without a cell phone. In your last three months, when you’re beginning your transition then you may use a computer to see what steps you might take in the broader community.

I remember one seeker saying to me, Beatrice, I can’t avoid myself here. I said, “Well, what do you mean? She said, “Oh, I don’t have Facebook.”

We don’t have radios. The same person asked in her first day when we were washing the dishes at night, can we listen to music as we wash up the dishes? Our guide asked her, “Well, do you sing?” She said yes. She burst into a beautiful Joni Mitchell song. The whole kitchen was singing as they were washing dishes. We’re really calling upon the creative forces within ourselves. You can deal without a cell phone for one year in your life.

Whitaker: Why do you call them seekers?

Birch: For many years, I worked in maximum and medium security prisons in New York. In one of the prisons, I would paint with the inmates. One day, a beautiful young man named Ian approached me. He said, Beatrice, I was trying to write to a friend on the outside about this art class, and it’s so hard to describe what happens. Eventually, I wrote to my friend, it’s an art class, but it’s really a spiritual class. Then he looked me straight in the eyes, and he said, this is what I was looking for on the outside. Is it strange I had to come to prison to find it? I was awed. I just looked at him, and my inner voice said, “You’re all seekers.”

You’re looking for something more than this fast-paced, superficial, materialistic life. When all this came to me, I had to start Inner Fire. I thought, well, what are we going to call the people who come here? We’re not going to call them patients or residents or clients. Then I thought of Ian. I thought they’re seeking. They’re looking for something more than the meds and they’re kindling their inner fire. Sometimes the inner fire is really almost ambers. Through our love and our enthusiasm, it kindles, and it’s beautiful.

Whitaker:  Tell us what the program is like. What is a day like at Inner Fire?

Birch: You’re down for breakfast at quarter to seven. You take your meds or your supplements or homoeopathy or whatever. We sit down to eat at 7:00, wash up at 7:30, and head out for a walk despite the weather. Two days of the week, we build a fire outdoors, Tuesdays and Fridays, sometimes in the snow, sometimes in the pouring rain. Boy, do the seekers work hard to kindle that fire even in the rain.

Then we have what we call a morning circle where, whether we’re outdoors or indoors, we go around the circle, and we share how we’re doing and what we’re grateful for. Then the day begins, and you’re in the kitchen learning how to cook. We’ve actually just started, we’re now in our third week of it, the keto diet. But it’s always been organic, biodynamic, whole foods, gut-friendly, no sugar. No caffeine, no nicotine.

You’re in the kitchen learning to cook so that when you leave Inner Fire, you can cook any way you want, but you can’t tell anyone you don’t know how to cook. Then you’re out in the garden, or you’re chopping down trees in the woods in the winter. One morning of the week, we do house cleaning because taking care of your own space is really important. Basically in the morning, it’s more like an out breath for the soul. You’re giving to the community, you’re needed, and you work together.

You have lunch at noon, and then everyone has a rest until 2:00. After that, we have massage, we have artistic therapy, a form of movement called Eurythmy and Spatial Dynamics. We have somatic experiencing, we have biographical work, we have the Alexander Technique, and various different therapies, sometimes three days of the week, sometimes one day of the week. That goes until 6:00. We try to always balance indoor-outdoor so that when a seeker leaves Inner Fire, they often say, well, I know how important it is to balance my day and my diet.

The evenings are really special. We have Monday nights, it’s sharing a question where whatever question is living within you, and we can talk about anything at Inner Fire, which is remarkable. I’m so impressed. The person will formulate a question, and then we go around the circle, and we listen to every different person’s perspective on this. It’s not dialogue. You formulate, then you listen to other people’s perspectives. Then Tuesdays is creative writing and poetry. Wednesdays are a free evening. Thursdays are music, where you’re making music, singing, drumming and guitar. People bring their instruments when they come.

Fridays are the soft and fluffy evening of the week, where you go around the circle, and you share what you appreciate about everybody in the circle, and then yourself. If you put that into a context, many people who come to Inner Fire feel awful about themselves. They’re so full of shame. They feel they’ve failed. They’ve done things in manic states that they’re embarrassed about. But once a week, you hear from a number of people what they appreciate about you.

To be honest, I’m in awe at what the seekers recognize in each other and can appreciate. It’s so — it’s even tear-jerking, it brings tears. I should say, tears are very welcome at Inner Fire. We’ve got to cry, and we belly laugh, so the whole spectrum.

Whitaker: That’s a beautiful vision of holding up a mirror to people that tells them they are worthy. That they can be with others. They have good qualities rather than a mirror that is held up generally in the system of a broken person.

Birch: One thing we do is encourage everyone to claim their voice. We want to hear anything. You may not get your way, but claim your voice. Also, a huge thing, one day I realized when I was leaving the maximum security prison that not one of those guys has a feeling in them that I don’t have in myself. I may not have had the life circumstances to experience those feelings, but don’t fool yourself, we have them all. Then I realized that’s what makes us brothers and sisters. What makes us unique is what we do with our feelings.

Whitaker: Tell us about staffing at Inner Fire, including, you said, it’s tough to get guides to stay. But  do you have a nutritionist? A psychiatrist?

Birch: We have a wonderful nutritionist and chef. She works with each of the seekers and teaches them how to cook. She’s very enthusiastic about the keto diet. We have a naturopath who’s been with us. A doctor who’s had some experience with the tapering process before coming to us. But what’s so beautiful about that is he’s with us three days of the week. He knows the seekers, and he and I together meet with the seekers once a week, and the tapering is very slow, very slow.

Then we have gardeners and woodsmen. We have a goat keeper, and we’d love to have more animals, but we have hens and so on. But going back to our doctor, it’s so wonderful to have somebody who knows the seekers so well. It’s not just seeing them once every two weeks.

Whitaker: Who are the guides? Are they people with lived experience? 

Birch: A spectrum, people with lived experiences are the ones who might have lived, or have worked, in homeless shelters or psychiatric hospitals. One of our guides said once, I have to leave my heart outside and go into the hospital and pick it up. They can’t stand the work that they have to do, but they’ve got to earn a living. They’re so relieved to come to a place where they can wholeheartedly believe in what they’re doing and help somebody reclaim their lives.

Whitaker:  We’ve presented a picture here of people working, people seeking, and of a life that is filled with nature. At the same time, I know there are difficulties working with people who come or are coming off medications, or even if they’re not coming off medications. Can you describe some of the difficulties you’ve had and how you’ve handled them? 

Birch: Every time it’s new, because everyone is so unique. We had one seeker who was suicidal before coming, and you’re always at Inner Fire for three weeks to get into the rhythm before you begin to taper. The day he was going to start tapering, he said to me, Beatrice, I’ve had no intrusive thoughts since I’ve been at Inner Fire, and it’s like, really?  Usually, the intrusive thoughts dissipate as they taper. I asked him why. He said, probably because of the diet and I’m doing meaningful work.

During his whole tapering process, he was fine. No intrusive thoughts. He eventually got off his meds, and he was fine for a few weeks, maybe even two months or so, because he stayed longer just to make sure. At one point, he said, I’m terrified of life. It is not what I thought it was going to be like, and soon after that, he slipped up into his head. He was imagining people were spitting on him. He was imagining that we’re out to get him and all these things, and it’s like, where does this come from? We ride the wave. We work with him.

But it also wasn’t shifting. So at one point, when we have this dynamic, we have to be a safe community. But safety is all relative. When people are coming off their meds, they’re going to say things that can be scary. But the next day, they can be fine. Our question is, when do we realize we can no longer help this person?

Whitaker: What happens when you realize that?

Birch: Sometimes we have to say to the parents, and this is something that you sign in the application form, if we can do nothing more, then you need to come and get your loved one. Or the spouses, we have couples who’ve come. That’s hard. It’s hard for us; we go so far with the person, and it’s hard for us to recognize when actually we can’t do anything more. But that seldom happens. It’s mostly people who go through, and they get jobs, and they go back to college, and they do whatever they do. But occasionally, we have those situations.

Whitaker: Now, Beatrice, I have to ask you this question. It’s well-known that there’s a concern that when people are coming off psychiatric medications, and particularly antipsychotic medications, there are occasions when violence occurs.  My question to you is, have you ever experienced any instances of violence at Inner Fire? 

Birch: It’s such an important question, and I’m glad you asked that. In our 11 years, we’ve had five acts of violence. Fortunately, not too serious. Nobody really got hurt, but it was violent. We have also had times where people have been verbally aggressive and threatening. But, that’s in almost 11 years, compared to what happens at psychiatric hospitals.

Whitaker: That’s an important point of reference. It’s not that psychiatric hospitals are  bastions of peace and safety.

Birch: Absolutely not. I mean, violence happens daily. To be honest, and it might sound surprising, Inner Fire is a pretty peaceful place. But there are reasons for that. I don’t think I would do this work if we did not have the program we have because you have to keep people grounded in their tapering process. It can’t just be talk. They’re learning things. They’re engaged, working their physical body. If someone is feeling really vulnerable, they’re so much relieved by physically digging in the earth or whatever they’re doing.

But I think it’s also so important to remember, anybody can go to the internet and read the side effects of these medications and the withdrawal symptoms, and suicidal ideation, danger to yourself, danger to others, and kidney failure. The lists are horrendous. It’s ridiculous.

What we always try to remember is that this is not the seeker himself or herself. This is the seeker trying their utmost to deal with the withdrawal symptoms or the side effects of these meds. It’s very important, and these acts of violence, I should say, happened in our earlier years. We’ve learned that everybody’s journey is unique. And everyone has had their own particular biography and how they’ve dealt with it, and the shame and the embarrassment and everything they’re still dealing with by being on these meds.

Whitaker: When you had these acts of violence, did you kick the person out of your program? Or how did you move forward after the act had dissipated?

Birch: In only one instance did we kick them out, and that’s because the person had a history of violence in the past. An unfortunate situation had happened where the person had been tapered too quickly. The violence surfaced sooner than it might have, but we’re quite sure it would have surfaced. Of course, we don’t push people when they need to have pauses and rests and that sort of thing. But if they just basically say, I’m not going to do this anymore, and they still want to taper, we will not help them because I don’t feel we can do the tapering without them fully engaged in all aspects of the program.

Whitaker: You said most of these incidents of violence occurred earlier on. What have you learned? What do you do differently now that you haven’t had such instances in the last,  I don’t know, three, four years?

Birch: First of all, the violence happened very quickly, very suddenly and actually it happened to me. What we try to do is anticipate more. If somebody is tipping a little bit into mania, they’re going to walk differently. We’re developing really a preventative. We anticipate it, we observe it. If someone is walking a bit too fast, or their eyes are flashing back and forth, or you know things are beginning to happen internally. That’s why we might say, okay, let’s go dig in the garden. And you dig. Then afterwards, they’ll say, thank you. That was exactly what I needed. In that sense, it’s preventative.

Whitaker: So, burn off the inner agitation.

Birch: Our focus on grounding is key. For instance, it dawned on me that once they’re in mania, it’s very hard to get them back. We have to prevent that.

Think about jump roping, right? You’ve got all this energy, and you have to stay in your body, you have to stay grounded. We jump rope, and we’re all out there jump roping together, so we’re not sort of just isolating one person to do it.

Whitaker: Beatrice, have you collected data that tells of what the results are? What are the outcomes with people at the end of one year? Two years later, three years later? 

Birch: That’s a very interesting question, and the broad answer is occasionally I hear from seekers. We’ve sent out questionnaires, but we don’t necessarily get responses from everybody. There was one person locally here in Brattleboro when I bumped into him, and I said, will you come back and inspire the other seekers? He looked at me, and he said, this has been such a part of my life, but I don’t want to go back. I want to go forward. I understood it. But eventually he did come back and inspired, and that was really wonderful.

If somebody would like to volunteer [to gather outcomes data], that would be great.

Whitaker: It would be great if someone could give a grant to an outsider to do this. How many people do you think you’ve had go through your program in 10 years?

Birch: We’ve had about 65. We’ve stayed small. But that’s good.

Whitaker: It would be very interesting to see how the 65 are doing. 

Birch: I agree. I could just say, I’ve been asked to start Inner Fires in Texas, Northern California, Michigan, Maine, the U.K., and Africa.

Whitaker: What do you tell them?

Birch: I want to finish the site here. I want to raise this 2.1 million [for the west wing]. Then what I want to do is to say that if you want to start an Inner Fire, come and live with us. It’s not a recipe. Drink it, breathe it, work it, see what happens, and then go back to your state or your country because we’ve had [inquiries] from people from China, Japan, India, Romania. An email from South Africa says knowing Inner Fire exists gives us hope.

Whitaker:  Last question. How rewarding has it been for you and the others who’ve worked at Inner Fire?

Birch: Incredibly rewarding. Incredibly. It’s so rich. I’ve always believed in the resilience of the human spirit, and now I see it, and the feeling of joy, really every night.  I’m in awe when I go to sleep. Awe and joy at seeing this resilience despite the hell people have gone through, and there’s still that Inner Fire. I mean, when a mother phones me and says, “Well, my son is considered non-compliant.” I said, they’re listening to their Inner Fire. Being non-compliant means you’re not doing what I want you to do, and it’s like, no, they’re listening to something else, you know.

Whitaker: Where can people find you? 

Birch: It’s www.innerfire.us, and if anyone is in the area and they want to come and visit, you’re welcome to contact me. You’re very welcome to come and have a look.

Whitaker:  Thank you so much for being with us today, Beatrice. I think one of the most important messages is how you’re hearing from people around the world because that speaks to this groundswell for thinking about people differently, thinking about these different dimensions of who we are. I think it’s obvious that you’re inspiring others. 

Birch: Thank you for your support, Bob.

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