Overcoming the Impossible

Psychologist Ronald Bassman, once diagnosed and treated for
schizophrenia,brings new hope to patients and families.

The seclusion room was empty except for a mattress covered in black
rubber on the concrete floor. They lowered me onto the mattress and
turned me on my side. I fought their grip on my ankles and wrists, but
they were too strong and experienced. I quit struggling and stared at the
wire-encased ceiling light. I couldn't see the nurse when she came in and
said, "Get him ready." They quickly pulled my pants and underwear down to
my knees. I winced at the violent thrust of the needle. I tried to
prepare myself to fight the onslaught of the thought-dulling,
body-numbing Thorazine.

They waited for the drug to take effect before they stripped me of
my clothes. I was left naked in the seclusion room, and no explanations
were given. They did not tell me how long I would stay there.

Three decades have passed since I've had any kind of psychiatric
treatment, yet the memories remain. Even after more than 20 years of work
as a licensed psychologist, the nightmares have not disappeared. The
dreams of endless wanderings through gauze-shrouded hospital corridors,
the disembodied screams, and the smothering restraints and seclusion were
not overcome by my successes. Those haunting memories only ended when I
was finally able to use all of my experiences, when I was able to stop
hiding my psychiatric history, and when I could speak publicly about my
own treatment and transformation. Now I understand the importance of
sharing what l learned from living and working on both sides of the
locked door.

I am just one of many who have suffered psychiatric torments from
an inadequate and often destructive mental health system. The journey
that brought me to this place of credibility enables me to offer my
experience not only to those who have the power to bring about change,
but also to those who feel powerless and need inspiration. My good
fortune allows me to challenge the prevailing psychiatric model. When you
become a mental patient, you are no longer regarded as a whole person
with an individual mix of strengths and weaknesses.

When I was discharged from the hospital I was told I had an
incurable disease called schizophrenia. The doctor told my family that my
chances of being rehospitalized were very high. His medical orders were
directed at my parents, not me, and stated with an absolute authority
that discouraged any challenge. He predicted a lifetime in the back ward
of a state hospital if his orders were not followed.

"He will need to take medication for the rest of his life. For now,
you need to bring him to the hospital weekly for outpatient treatment and
he must not see any of his old friends."

I was devastated.

The hospital doctor put me into a coma five days a week for eight
weeks by injecting me with insulin. Those 40 insulin treatments combined
with electroshock blasted huge holes in my memory, parts of which have
never returned. I ballooned from 140 to 170 pounds; I appeared the clown
in clothes that no longer fit. My already damaged self-image had
plummeted to an unrecognizable depth, and the heavy doses of Thorazine
and Stelazine made me feel like I was walking in slow-motion under
water.

Was the doctor joking? Not see my old friends? How was I going to
face them and explain what had become of me? Did anyone really think that
I was capable of making new friends? I was sure that they would have
nothing to do with me. But the most disturbing of all the orders was to
hear him say that I would never be free of the hospital's control.

My best friends were once locked up in mental hospitals and fought
their way back. We are psychiatric survivors. Some believe that
psychiatric survivors defy the odds. Or maybe we were never really
mentally ill, just misdiagnosed. After all, they say schizophrenia is a
lifelong disease. Such reasoning makes my peers and me look like
exceptions. Among our large group of closeted ex-patients are lawyers,
teachers, mechanics, doctors, carpenters, plumbers and psychologists. We
are your neighbors, ministers and friends, living and working in your
communities. Many thousands choose not to reveal their past.

I choose to speak and write about my experiences so that others who
have been diagnosed and treated for serious mental illness will be able
to see new hope and possibility. After speaking engagements, I often get
calls and letters from people who are thankful that Someone is speaking
out. They hide their past just as I did, but go on with their lives
without anyone but their friends and families knowing about their
psychiatric histories. Sometimes psychology students ask for advice about
whether they should disclose their past. They are stung by the
insensitivity and misinformation perpetuated in their programs. But those
students suffer silently. They know it is not in their best interest to
disclose their histories if they expect to succeed.

For the past five years I have presented psychiatric survivor
concerns at lectures and symposiums at the American Psychological
Association's annual convention. I have tried to connect with other
psychologists who have been diagnosed and treated for major mental
illness. At the annual conventions, I hold a meeting for psychologists
who have psychiatric histories as well as those who are interested in
serious mental illness. I have tried to make it a safe place for people
to meet without feeling that they are at risk of being exposed. They can
choose to participate as an interested psychologist if they feel
uncomfortable about revealing their experiences.

Over the years, psychologists have come to our meetings and talked
about their experiences as mental patients. Some disclosed their past for
the first time. But in this organization comprising more than 130,000
members, with an annual convention that draws between 20,000 and 30,000
psychologists, only 15 have felt safe enough to reveal their
histories.

Do we recover or are we transformed by our experiences?

Some of us think of ourselves as recovering or recovered. Others
like myself see it as a process of transformation. Like other psychiatric
survivors, I feel duty-bound to share what helped and hurt me so that we
may eliminate the ineffective treatments and abuses of the mental health
system, and help make our communities more supportive and
inclusive.

yet how does one climb from the depths? Research from around the
world documents high rates of complete recovery from schizophrenia. The
most extensive study, known as the Vermont Longitudinal Study, followed
patients for an average of 32 years. Lead researcher Courtenay Harding of
the University of Colorado studied the most "hopeless" patients diagnosed
with schizophrenia: the feces-smearing patients who barely dressed
themselves and had forgotten how to tell time. Harding reported that 30
percent of these patients had fully recovered. These ex-patients were
symptom-free, employed, had a social life and did not take
medication.

During my own struggles it would have been extremely helpful to
have known of this optimistic research. Yet even with such remarkable
findings, the common belief remains: Recovery is rare or impossible. In
forums and presentations, I've shared these research findings and found
that most people are surprised by the results.

Another study conducted by the United Nations through the World
Health Organization found that people diagnosed with schizophrenia in
Third World countries have higher rates of recovery than those who live
in First World nations. Why is this? The thinking has been that families
in underdeveloped countries need each member to be productive. Therefore,
there may be greater tolerance for people who look and act differently.
These people are necessary to their families and community. They have
value.

What makes recovery and transformation possible? Unlike the
research on recovery rates, there is little quantitative research on what
promotes recovery. To determine what is helpful, we are guided by
qualitative research gathered from people willing to share their
stories.

in the Vermont study Harding masked people, "What really made the
difference in your recovery?" Many of them answered similarly. They
looked down at their feet, shuffled around and said something about a
person who told them that they have a chance to get better. Having
someone believe in them translated into hope. Without hope, death can
establish a foothold. Hope fights fear and nurtures courage. It inspires
vision and the work required to realize the unattainable.

Pat Deegan, a psychologist and psychiatric survivor, was diagnosed
with schizophrenia at 17 and hospitalized nine times. She is currently
director of education at the National Empowerment Center in Lawrence,
Massachusetts. When Dr. Deegan talks about recovery, she often tells a
story about how her traditional Irish grandmother reached out to her.
When she was discharged from the hospital, Pat spent days sitting in a
chair doing nothing but smoking cigarettes and drinking Cokes. Every day,
her grandmother came in and asked her if she wanted to go to the grocery
store with her. It was not a demand, just an invitation for company. For
months Pat refused. One day she agreed to go with her grandmother, but
stipulated that she would not choose anything or help in any way. It was
a beginning. Her grandmother valued her company and believed that she
could do more.

It isn't one person or incident or clinical intervention that is
critical for change to occur. Instead, it's a complex process. One
essential factor is keeping the spirit alive. Connecting with others
helps: Receiving respect and warmth breaks through the isolation and
helps you feel worthy and alive.

Deep in the recesses of our being there are safe sanctuaries,
secure hiding places for salvageable dreams. Anger sustains our stubborn
refusal to accept others' dire predictions. Anger protects our hopes and
dreams.

Author and international lecturer Judi Chamberlin writes proudly
and sardonically about having been a noncompliant patient. Non-compliant
patients receive the worst and potentially most harmful treatments. We
have been locked in seclusion, placed in restraints, chemically and
physically straitjacketed, lobotomized, shocked and beaten because we
protested too much. If we were lucky enough to escape permanent damage,
anger helped us. It helped us fight for our rights and shun the role of
lifelong mental patient.

Anne Krauss, a psychiatric survivor working in the mental health
field in New York tells an illuminating story of the effects of
suppressing anger. She worked as a peer advocate in a state psychiatric
hospital, and on one occasion she was in the ward talking with a patient
for whom she was an advocate. Knowing that her complaints were
legitimate, Anne listened respectfully to the woman as she angrily
complained about not getting what she wanted. At the time, a psychiatrist
assigned to the ward who knew both Anne and the patient walked over and
placed himself between the two women. He faced Anne and said, "You know,
some people just don't know that they should not be angry with people who
are trying to help them. They would get along much better if they showed
more respect." After he walked away, Anne resumed the conversation. The
woman was no longer lucid. She ignored Anne, and began talking to the
voices only she could hear. Anne was stunned by this example of the price
paid when you are forced to bury your anger.

Darby Penney is director of the Bureau of Recipient Affairs for the
New York State Office of Mental Health. In her cabinet-level position,
she supervises a staff of 14 and reports directly to the commissioner of
the world's largest mental health system. Darby tries to infuse her work
with survival lessons she learned during her stay in psychiatric
hospitals. In the hospital you are asked to talk about your feelings, but
when that emotion is actually felt and expressed, you suffer the
staff-imposed consequences. If you cry, you are considered suicidal. If
you're angry, you are aggressive and dangerous. And if you are laughing
too happily, you are manic and need to be sedated.

Each of us defies set formulas. The timing and options are
different for each of us. What is helpful is the right to take risks--the
opportunity to fail or succeed, as well as the freedom to make decisions
and choices. Without risk, without choice, the whole process is perverted
into, stabilization and maintenance at best and incarceration at worst
but never growth and development.

When people who have been diagnosed and treated for serious mental
illness work and play side by side with others, they will be seen and
valued for who they are with all their strengths, weaknesses and foibles.
By demystifying madness, we can begin to appreciate the beautiful gifts
that diversity offers to everyone.

THE BASICS OF RECOVERY

Remaining hopeful and envisioning a future of growth and
development.

Having the right to choose--without it there is no
motivation.

Knowing that you are not a label or a diagnosis. You are a living,
changing person--not an object.

Speaking for ourselves. When others speak for us we are
devalued.

Establishing our own homes in the community where we can choose our
roommates or live alone.

Acknowledging the need for friends, peers and intimate
relationships.

Realizing that peer support and self-help keeps us grounded and
connected.

Protecting and nurturing the spirit within us.

Knowing that all things are possible and that to be alive is a
miracle.

Other essentials include; safe niches, natural supports,
reconciliation with family, self-discipline and will, belief in oneself,
successful experiences, meaningful work, psychotherapy, and the passage
of time.

READ MORE ABOUT IT

The Heroic Client, Barry L. Duncan and Scott Miller (Jossey-Bass,
2000)

Unequal Rights: Discrimination Against People With Mental
Disabilities and the Americans With Disabilities Act, Susan Stefan
(American Psychological Association, 2000)

ILLUSTRATION (COLOR)

Adapted by Ph.D.