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Here in the East Bay, where so many revolutions find a footing, a whole spectrum of people such as McNamara and DuBrul find themselves somewhere between the pill-pushing psychiatrists of the modern Western medical establishment, and the ideology of those who believe there is no such thing as a psych disorder. Many of the movement's reluctant members are distrustful of both camps, and focused on making their own way in a world more likely to mistrust them.
McNamara, 25, whose bare feet, makeup-free face, and tousled brown hair resemble a natural-look version of Ally Sheedy in The Breakfast Club, felt devastated when she failed in her first steps toward self-sufficiency. "I was building a lot of my identity around being a person who had learned how to take care of herself, and I was really excited about not being on the medications," she says. "So being back on them was an extremely difficult thing to decide to do. ... You want to talk about something that blunts your senses; antipsychotic medications blunt you intensely." But then again, "sometimes when you're hearing voices telling you to kill yourself at four o'clock every day, being blunted is not such a bad thing."
McNamara had been three weeks away from getting her art degree from the San Francisco Art Institute. She is confident that most any shrink would have put her back on medication six months before she finally sought them out herself. "But I made the most amazing art I've ever made in my entire life," she says. The work that hangs around her studio in the project's offices attests to this. The last oil painting she completed while off her meds is a rich mix of a highly realistic landscape and abstract elements. She also worked on some detailed smaller pieces during that period. Further illustrating the point are the oils she has been painting since back on lithium and Lamictal -- all unfinished. But McNamara cautions not to make too much of the wild, powerful creativity so often romanticized in manic-depressives. Although TheIcarusProject.net features a "Dangerous Gifts" section, which features art and writing by project members on the links between creativity and madness, the site's real gift is that of the community it creates.
A growing body of research and experience suggests that community may be more important than other forms of treatment. In 1967, the World Health Organization launched the International Pilot Study on Schizophrenia, initially to find out if the disease existed internationally. Thirty-five years of study eventually showed that people diagnosed with schizophrenia fare remarkably better in poorer nations: There were fewer overnight hospital stays and higher employment rates in Nigeria, Chile, and India than in the United States, Germany, and the Netherlands. Even more shocking was the finding that between one half and two-thirds of people in developing nations recovered fully from the disorder. No delusions, no catatonic states or hallucinations, no disorganized speech, nothing.
"When a new psych drug comes out, and it's like a few percentage points better than placebo, it makes big news, right?" asks David Oaks, cofounder of MindFreedom: United Action for Human Rights in Mental Health, an independent mental health organization. "But there's something in poor and developing countries that they're doing that's twice as good."
Oaks, like many who have read the World Health Organization study, points to the closer community and family ties in these developing nations, and "greater tolerance of unusual thoughts and beliefs, seen often through a spiritual lens." For instance, many schizophrenics in India are able to work low-paying jobs, therefore remaining a part of the economy -- as opposed to in wealthier nations, where they're unlikely to be employed, and may be on disability, or homeless. In poorer countries, schizophrenics' families sit in on doctor-patient conferences, participating directly in their care.
As a working-class kid putting himself through Harvard in the mid-1970s, Oaks himself ran into emotional problems and was diagnosed as a schizophrenic. By the time he graduated, he'd been locked up in the psych ward five times. Today he compares the experience to a vision quest, which led him to write his senior paper on human-rights work, and eventually work in the field as a founder of one of the world's most established independent mental health organizations.
MindFreedom grew directly out of the psychiatric survivors' movement of the 1970s, much of which began in the Bay Area with the Network Against Psychiatric Assault and the Madness Network News. Although MindFreedom is now based in Eugene, Oregon, it recently opened offices in San Francisco, and brought several seminars to the area during July, which is known as Mad Pride Month.
One such talk was by Dr. Daniel Dorman, an assistant clinical professor of psychiatry at the UCLA School of Medicine. Dorman was joined by his formerly schizophrenic patient, Catherine Penney, now a psychiatric nurse and semiprofessional flamenco dancer. When the two met in the 1970s, he was in his first year of psychiatric training, and she was nineteen, institutionalized, and catatonic. For two years, Penney kept her eyes almost completely closed at all times, and shut herself down so completely that she would sit drooling in the hospital day room, her saliva dangling from the hem of her gown into a puddle on the floor. Diagnosed as schizophrenic, when Dorman began treating her she had been on the antipsychotics Thorazine and Stelazine for nearly a year -- plus the antidyskinetic Cogentin to control the tremors and muscle stiffness caused by the first two.
He saw Penney as suffering from a halt in her psychological development, not from a brain illness, and he worked on getting through to her personally, without drugs. "He always appealed to the well part," she says. "I never got the feeling that I was crazy or insane or hopeless. And he always listened; even when I was delusional about things, he could always get underneath the delusions to grasp at the kernel of truth that is always there in a delusion."
The Beverly Hills-based doctor, while not exactly hostile to medication, has taken a decidedly individualized, humanitarian approach in his career. "I'm sorry that psychiatry has abandoned so much of its former concern for the human soul and the insides of the human being in favor of a mechanistic, medical model approach," he says. "In psychiatry, we don't have to take responsibility. If our kids are out of control, we label them ADD. If I'm upset, then I label it clinical depression. If a person beats up his wife, he suffers from anxiety disorder. If a man is too shy to go out with women, we call it erectile dysfunction."
And if a man speaks out against psychiatry, we call him a Scientologist.
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