Friday, 20 February 2009

Take These Broken Wings. Recovery from Schizophrenia Without Medication. A documentary by Daniel Mackler

Last month, Gianna had a post on her blog, announcing New York-therapist Daniel Mackler's documentary Take These Broken Wings. Recovery from Schizophrenia Without Medication.

I'd been visiting Daniel Mackler's website a couple of times in the past, and thought 'I need to get hold of this, it can only be awesome.'

And awesome it is! The film's main interest is to show that recovery from what psychiatry calls "schizophrenia" is possible, that "schizophrenia" is not per se a lifelong, chronic condition, that needs lifelong - and, by the way, often chronifying - medication. And, in fact, as the documentary looks at both the scientific data, reported by Robert Whitaker, the stories of Joanne Greenberg and Catherine Penney, told by themselves, and the experiences of several professionals, among them Peter Breggin, Ann-Louise Silver, Bertram Karon and Daniel Dorman, it becomes, once more, clear that recovery, full recovery, from "schizophrenia" isn't only possible, but should be expected as a matter of course.



There are especially two among the many aspects in regard to treatment and recovery the film mentions, that are intriguing to me: the difference in quality of a recovery, that is achieved without drugs, compared to a "recovery" on drugs - if at all a recovery, that still requires maintenance medication, can be termed as such - on the one hand,



and the stark discrepancy between today's "best practice" and the kind of help for people in crisis, Peter Breggin among others, advocates for, on the other.



What does it tell me about our society in general, our culture's preferences, that we, in spite of a fundamental lack of proof for its efficacy and in spite of the fact that alternatives, that have been proven to be efficient, are available, nevertheless continue to almost exclusively treat "the most vulnerable people" in the most inhumane way imaginable?

Although the film focusses on psychotherapy as treatment, Daniel Mackler acknowledges, that this is not the one and only way to recover from "schizophrenia". All roads lead to Rome, one might say. All but one.

Just as the stories of most - if not all - people diagnozed with "schizophrenia", also Joanne Greenberg's and Catherine Penney's stories are stories of childhood trauma, while their recovery stories are those of becoming aware of the trauma, working it through, understanding it - and their reaction to it. And, obviously, there are many ways of becoming aware and understanding. While there is one way, that more efficiently than anything else suppresses, even reduces, awareness and understanding, and turns out to be a dead end in the long run: lifelong "maintenance" medication, in combination with the conviction, that "schizophrenia" is a chronic, biological brain disease, caused by a chemical imbalance, its "symptoms" thus being completely without meaning, and not worth being subjected to a closer investigation - with the guidance of a psychotherapist for instance.



Take These Broken Wings is a brilliant defence of not only psychotherapy, but all alternative approaches to crisis, that aim at understanding rather than at the mere suppression of "symptoms". At the same time it manages to, convincingly, debunk the medical model, while it navigates successfully around the trap of carrying on an aggressive controversy against psychiatry, or glorifying crisis as such.




The cutting of Take These Broken Wings with rather rapidly alternating sequences from the various interviews, that serve as the film's basis, and its subtle humour and poetic choice of images, make Take These Broken Wings also on an artistic level a treat to watch.

If there is one thing about this documentary, that is a little disturbing in my opinion, it is the collision of its philosophy with its terminology. And since I regard language as extremely important - as a means of identification - I couldn't but had to let Daniel Mackler know about my concern:

"The whole concept is so refreshingly non-pathologizing, and then, anyway: 'mental illness', 'schizophrenia', 'the schizophrenics'. 

I'd so like to see that label abolished. And the pathologizing of these states of mind, it inevitably comes along with, no matter what. In retrospect, I realized, that all that had happened to me was nothing but a somewhat 'exaggerated normality'. With the extent of exaggeration of my reactions perfectly corresponding to the extent of exaggeration of the circumstances, my experiences were a belated reaction to. That seems pretty natural, even healthy to me. Not at all ill in any way. I'd say, it would have been 'ill' to react less exaggerated. The question is, if 'illness' is something that threatens one's - physical or mental - health (like the traumatizing abusiveness of our civilization), or if it is one's natural, self-preserving reaction to the threat, that is the 'illness'. And where would one draw the line between 'normal' confusion, fear, anger, and 'schizophrenia', i.e. a whole lot of confusion, fear, and anger? Personally, I wouldn't venture to think, that I ever could. Joanne Greenberg says at some point, that 'every schizophrenic knows how sick he is,' and that she thinks, 'he knows how far he is from the center of his own being.' Well, when I look around, I see almost nothing but people, "normal" people, who are miles and miles away from the center of their own being. They're just not aware of it. If 'schizophrenia' exists as an illness, these people are the 'healthy' ones, while those, who are becoming aware, are the 'sick' ones. Definitely. But if being this far away from the center of one's own being is the real illness - and I tend to believe that - then the so-called 'schizophrenics' are the ones, who actually are recovering from this illness called 'normality'.

This maybe sounds a bit far-fetched, but nevertheless I think, it hits the nail on the head: one of Germany's leading experts in horses once said, that there is no horse, who is too sway-backed, too short-legged, too nervous, or too whatever. There only are horses who are sway-backed, short-legged, nervous, etc. Now, 'schizophrenia' sounds to me like 'too afraid, too confused, too angry'. While I think, there is no such thing as 'too' in regard to (human) behavior, in regard to (human) emotions and reactions.

To me, having to label myself explicitly (for holy, indispensable insight's sake...) was maybe the most painful experience throughout the whole therapy process. Just as I'd thought that eventually someone was really seeing me, this someone asked me to close my eyes to myself, to explain myself away, instead of to become aware of myself. Anticlimax."

Well, there is an explanation for the film's choice of terminology. And there also is this guy, at Washington Square Park, who says: "It's a gift, not a mental illness, a gift." He's right. That's what it is.

You can order the film here, and watch the trailers and more clips at Daniel Mackler's YouTube channel.

13 comments:

Kristo said...

Thanks for sharing these brilliant video's. Also take a look at http://www.kaia.ca/Documentary_SpiritualEmergency.php and the trailer is on my website: A must see documentory from an experienced so-called bipolar 1, psychotic former patient who went through a kundalini awakening after meditation. It was like 1000 Volts movings through my body. I really appreciate all the people in the Spiritual Emergency Network founded by Dr Stanislav Grof, and also Dr Roberto Assagioli made sense to me, as did shamanism and theosophy. My theosopical teacher calls me a 'shaman' instead of a 'mad man'.

Thanks a lot,

Kristo
Singer-songwriter and poet
Bachelorstudent in Psychology
Volonteer in society as a journalist/writer
and blogger

www.myspace.com/kristopop1983

Marian said...

Kristo: I read your story at Gianna's blog, and went to watch the trailer at yours (my Flemish - guess, that's the language you're writing in, isn't it? - isn't exactly advanced, but I do get most of it). Definitely a film I see forward to watch!

I think, "shaman" is so much more to the point than "bipolar" or "schizophrenic", or whatever of all that pathologizing bs. Much of what Sean talks about in his latest vid really resonated with what I've experienced during my last "psychotic break". So, was I "sick in my head", was I the "schizo", the "patient", my therapist saw in me? Or was I experiencing a spiritual emergency, a spiritual/Kundalini awakening?? (A rhetorical question.)

Kristo said...

Well from my experience working with patients as a volonteer, every client is different. Even the shamanic traditions seems to distinguish between people who get stuck in the illness, and people who become better. I guess doctor Stanslav Grof did some pioneering work with his book 'The Stormy Search For The Self' where he tries to develop a model with characteristics for the chronic psychotic patient and the wants who can heal. Even in Soteria house, there seem to be 15% of the people who still remain sick. But 85% who get better without medications. One of the problems is coping with violence and agression within patients when they regress and go through there process. I had a friend who became extremely paranoid psychotic and tried to kill his parents which ended in a bloody massacre. Nobody got killed but he had also together with his psychosis a tendency towards antisocial behaviour. I his now in jail under supervision of the government and will be forced to undergo treatment in forensic psychiatry. The same happened in my country no so long a go where a 20 year old man in a psychotic state, while hearing voices, killed an old woman, a nurse and 2 babies.

I think the majority of the psychotic people can heal if there are people around them with insight in altered states of consciousness, but there aren't many of them because the healed psychotic patient has reached a higher level of consiousness, love and care than the average psychiatrist I guess. I'm happy to see that in the Netherlands they start to recrute psychiatric survivors within the mental health system. Believe me, on our universities, they don't teach you someting like transpersonal psychology, only at Naropa University in Boulder - United States - I guess.

Unfortunately, most of the tradional psychiatrist think that all of the psychotics are potential murders, like those few cases I just mentioned, while the opposite is true. The best thing we can do is try to build a bridge between traditional mental health care and our pioneering work. Not all medications are bad, they can save lifes in some cases, but the mental health system is overmedicalised and the pharma industry is making big money of it. I don't see that change quickly, unless we keep on writing about it and inform the people. Ken Wilber's Integral Psychology is in intresting approach, but he misses the insight that psychotics can heal. The Integral approach is very good, but Stanislav Grof, Loren Mosher and John Weir Perry, als Assagioli, are more the ones we need.

I hope it's more clear for you now.

Kind regards,

Kristo

Belgium

Kristo said...

So my conclusion is from the approach of integral psychology: try to get the best cure with the best patient. I recommend all of the video's made by Sean Blackwell from Brazil on my website: http://marsraker.blogspot.com/2008/11/levels-of-consciousness-spiral-dynamics.html

Further reading on Spiral Dynamics and integral thinking is very interesting to put all things together in the right fraimwork.

Marian said...

I've seen all of Sean's vids, and read his book, too. Haven't read Grof nor Wilber yet, though.

IMO, the trouble with the current mh system is that the vast majority of the "healers", as you mention, are just as unconscious as the people they want to heal. Only a somewhat unconscious person would ever project his/her own existential fears and insecurity into another person's extreme experiences, and dismiss these experiences as "illness" - i.e. as the meaningless product of a meaningless brain disease, that has to be suppressed and controlled by all means, instead of explored with an open mind - as it is done under the current paradigm.

Violence is always the result of fear, of feeling threatened and cornered ("paranoia"). It never just happens without reason. It's a more or less desperate defence mechanism. And I find it thought provoking, that it happens a lot more often at locked wards than in any other setting, coming along both in the shape of aggression towards others and in that of self harm.

Also in regard to violent behavior: the current paradigm in psychiatry describes it as a completely unpredictable action (not a reaction, and oftentimes, though not always, even predictable), the product of a "broken" brain, thus creating a fear in society, that again leads to aggression (rejection, discrimination, marginalization, dehumanization...) towards the people, whose brains allegedly are broken. A vicious circle. While, as I see it, the real violence is that of society, not that of people, who try to defend themselves from this society's violence towards them.

And yes, there's a small number of people, who got so hurt, they've lost every trust in humanity, once and for all. I can't even blame them... I think, we ought to offer them safe places to stay, where they are treated with dignity and respect, instead of just warehousing them, and maybe even (ab)using them as guinea pigs for new medications and whatnot.

Kristo said...

I understand what you mean. Keep up the good work!

Kristo

not important said...

I study Buddhism, and have also read extensively concerning such topics as spirituality, Native American religions, and Carlos Castaneda. I also have a master's degree in social work. I, too, always tried to ignore labels, "diagnosis", and just tried to get to know someone, let them tell their story, and validate their pain, and encourage them. I often incorporated Buddhist philosophy into my sessions.

My own 18 year old son was recently diagnosed with schizophrenia following a very definite and complete "break-down" in January. He was hallucinating severely, and very delusional.

I have always been quite skeptical and fearful of medications. I did not hospitalize him, but had to quit working and keep him home at all times to protect him. Out of extreme distress, suffering, and fear for him, I did take my son to a doctor, and did start giving my own son an anti-psychotic medication. Those symptoms did fairly quickly subside over a few weeks. I plan to continue the meds. for now, but I must admit I am both very scared to continue to give meds. to him and also very scared to stop giving the meds.

I do believe in recovery, and continually tell him I know he will get better, which he does believe, perhaps partially because he trusts me. I love my son very much, and have always been very open-minded with him.

He is strongly against seeing a therapist. I will not try to push him to do so.

This has been very confusing and very, very difficult for me. Seeing how he was feeling and behaving before the meds., as my own dearly loved son, I am no longer able to be "objective" in any way. After the horrifying and traumatic experience I have been through watching my son suffer, I am having a great deal of difficulty tapping into my intuition or gut instincts or whatever you want to call it. I am watching and listening for a sign to tell me what I should do next. But will I be able to recognize it? I have no idea.

Marian said...

not important: There's no denying that crisis can be and often is extremely tough to get through without drugs, for everyone who's involved, and especially if you're alone supporting your son. I only made it because of the factors I list in this post. And it took both me and most people I know, who chose to do without drugs, more than one crisis to eventually figure things out, and reach a level of awareness, that makes crisis unlikely to repeat itself. Probably even more unlikely to repeat itself than it is likely for any one "normal" person to experience crisis.

The maybe most important factor in my own recovery was my determination combined with the insight, that I was stuck, that I'd lost my way, and needed someone else to help me find it. And although I felt a desperate need to talk to someone, I had to force myself to ask a professional, a therapist, for help. Because asking for professional help somehow equals to admitting, that something's wrong with oneself. Nothing was wrong with me. I imagine, this could be the reason, why your son doesn't want to talk to a therapist. And I can't blame him for that. Nothing is more devastating, than having one's experiences devalued as "insane". Unfortunately, therapists like Daniel Mackler, who respect their clients unconditionally, and don't pathologize, are rare these days. I only succeeded to ask for professional help, because I was a lot more scared of ending up committed to a locked ward. And I only stayed in therapy, because the disrespect I experienced there didn't exceed a certain tolerable level.

Nevertheless, crisis is a wake-up call, and it doesn't just evaporate on its own. If it isn't listened to and understood, it will happen again and again. Drugs can suppress it to a certain extent, but they can't make anyone understand. On the contrary, usually they also suppress understanding. And they have a whole lot of really damaging side effects. But I guess, I'm not telling you anything new here.

It's up to your son. As far as I can see, you can't do more, than what you already are doing. You can't take him through a crisis all alone. You'll need some more support. On the other hand, pushing him won't do either, no. It has to be his own decision.

I hope, your son finds his way, and I wish, there were safe places like Soteria houses everywhere, where people in your son's situation could go and get unconditional support, so that you wouldn't have to deal with this all on your own.

Take care!

not important said...

Thank-you, Marion, for your support. I agree that it is up to my son. He is very young, though. Trying to make sense of this crisis would be very difficult for anyone especially such a young man. He has talked about having an awareness that something strange was happening to him, and said he was successful for a time in trying to fight it, before he totally lost that awareness, and became lost.

He does not want to talk to a therapist because he does not think it would be helpful. He knows someone his age who was diagnosed with schizophrenia a couple of years ago, took meds. at first, then refused to take them any longer. He told my son he knows what his own "triggers" are, and is now able to avoid them. My son said he will take the meds. for awhile, but eventually wants to stop, and said he believes he will be able to avoid another crisia because he knows how now, having learned from his experience.

Marian said...

not important: There are basically two different approaches to deal with emotional distress without drugs: 1. learning how to avoid one's personal triggers, and 2. neutralizing those triggers.

A friend of mine once stated, that she regarded it her own responsibility to work towards neutralizing her triggers, because they weren't only limiting to her, but also to her surroundings: "I can't do this, I can't do that, because it's a trigger to me." Or: "Don't do this, don't say that, because it's a trigger to me."

Of course there are "triggers", that simply should be avoided. Such as not getting enough rest, living on junk food, being constantly exposed to stress, leading an unhealthy, unnatural lifestyle in general. But these are things, that can drive anyone crazy.

On the other hand, if I had chosen the path of least resistance (apart from taking drugs, that is), I wouldn't be able to cope with things like my own name*, or talking about my mother, today. I wouldn't be able to attend any events, that imply the presence of more than two or three other people, and I wouldn't be able to watch TV. I know quite a few people, who have difficulty dealing with things like these, who never got past it. Because they chose to avoid, instead of confront, their triggers. It's not their fault. It's the system, that usually tells people, avoidance is the only option they have. And, indeed, most therapists are experts in teaching people how best to avoid, even flat-out refusing to engage in any kind of trauma-related work with their clients. Because it's so much easier and less painful to avoid, also for the therapist.

Avoidance can be some sort of "solution". But it doesn't eliminate the possibility, that there might emerge a situation, where one or the other trigger takes you by surprise. You can't really relax, have to always be alert. Which I personally find limiting and stressful.

Another aspect is, that I, sort of intuitively, felt, that there was something essentially important to my experiences, that I simply couldn't just ignore, but had to explore. So I actually sought out my triggers whenever possible. Which, of course, isn't without risks, and can't be recommended, unless you have some kind of support.

You write, that your son tried to fight it. "What you fight, you strengthen," comes to mind here. And, indeed, the more I fought, in the beginning, the worse things became.

You - and your son - may want to check out the documentary The Doctor Who Hears Voices, and Sean Blackwell's videos on YouTube, especially this one. Sean primarily talks about "bipolar disorder/mania". Nevertheless, what he says applies just as well to any kind of "psychosis". - And I want to mention, that I don't agree to every single statement of his. Some of it seems a bit élitist to me (Ken Wilber). Still, his videos communicate some essential truths in a very clear cut way.

Last but not least a warning: Be very careful when quitting the drugs! All psychotropic drugs are physically addictive, which means that most people experience more or less severe withdrawal symptoms when tapering off. And no one should ever quit cold turkey. Quitting cold turkey or tapering too fast is the most common cause why people fail to manage off the drugs. Often it even lands them in the hospital (again). Check out the "Coming off psych drugs" section in my sidebar. Gianna's blog Beyond Meds is probably the most thorough and complete resource on coming off, that is available on the net.

Marian said...

* I did change my name, thus practising avoidance, due to the fact, that I couldn't deal with my given name for some time. I can today.

Anonymous said...

great post

Marian said...

Anonymous: Thanks. It's a great film. Hope, you'll get the chance to watch it in its entirety, if you haven't yet.