Soteria was “a special and more-than-good place” where people were treated with dignity and respect, compassion, understanding, love, and healing relationships. Since they were not dumbed down with neuroleptic drugs they could relate to, and learn from, its special environment.”(Loren Mosher MD) Mosher spent his professional career advocating for humane and effective treatment for people diagnosed as having schizophrenia and was instrumental in developing an innovative, residential, home-like, non-hospital, non-drug treatment model for newly identified acutely psychotic persons. This psychosocial milieu-based residential treatment, known as the Soteria Project, showed consistently that its approach — a special social environment where drugs were generally not given — produced equivalent or better outcomes for patients treated there at 6 weeks and 2 years when compared with individuals that received “usual” hospital and neuroleptic drug treatment. Despite superior results compared to standard drug treatment, further funding for the Soteria Project was denied because, according to Mosher, the politics of psychiatry were increasingly controlled by the influence of pharmaceutical companies.
Similarly, Open Dialogue demonstrates far superior results as compared to USA standard care (drugs, hospitalization). Harvard’s McLean Hospital has adopted this approach. Open Dialogue is an innovative bio-psycho-social-spiritual network-based approach to psychological and emotional healthcare. Decades ago, a multidisciplinary team in Finland transformed the entire public psychiatric system from an old-style “chronic” hospital into an acute, community-based therapeutic facility. After five years, 80% of those suffering acute psychosis for the first time in their lives experienced functional recovery (Seikkula et al., 2006). They were working, studying, or looking for a job and not on government disability. Open Dialogue may have the best outcomes in the world for psychosis (dialogicpractice.net).
Anyone can experience psychosis, by the way. People struggling to acknowledge and live in reality are people struggling to get through life just like everyone else, each for different reasons, some more obviously than others. If we truly desire to help people who struggle and suffer, we need to wake up.
The biomedical-reductionistic paradigm is “a history and science of a failed paradigm of care.” (Robert Whitaker, www.madinamerica.com). The ethics that flow from that system do not reflect the realities of human nature and conduct, nor the possibilities of human choice. Consequently, standard remedies miss the mark. For example, according to Whitaker (Suicide in the Age of Prozac, 8/6/2018), there is a “body of collective evidence suggesting that mental health care, when it focuses on treatment with antidepressants, raises the risk of suicide at a general population level . . . the medicalized approach to suicide may make things worse.”
The medicalization of human life and living is an abomination. Extreme experiences of emotion and distortions of thought processes belong to the human condition. They are meaningful, and, if allowed and with proper care, often resolve. Whatever the experience, be it psychosis, depression, emotional instability or anxiety what is missing in our current conceptualization of “care”, and therefore needed to revolutionize our approach to madness and human suffering, is the understanding that symptoms arise in the context of human relationships.
The ethics that flow naturally from this understanding will be consistent with the practices of Soteria, & Open Dialogue, and, the results of the longest running study on health & happiness:
- treat people with dignity and respect, compassion, understanding, and love.
- quality human relationships are more important than cholesterol, fame or fortune
- Response by Dr. Mosher to Psychobabble Scars, San Diego Weekly Reader, May 24th, 2003, Letter to the Editor, by Carla Jacobs
- Robert Whitaker, Author of Mad in America: Bad Medicine, Bad Science, and the Enduring Mistreatment of the Mentally Ill
- Antipsychotics in Open Dialogue Treatment: a best use model of care, Robert Whitaker, April 2013
- dialogicpractice.net The Promise of Open Dialogue, January 1, 2014
- The History & Science of a Failed Paradigm of Care, Robert Whitaker, April 2016
- Psychiatrists Defends its Antipsychotics: A case study of institutional corruption, Whitaker, 5/22/2017
- Causation not just correlation, Whitaker, May 2016
- Do Antidepressants work? Whitaker, 3/12/18
- Drug Treatment in Medicine and Psychiatry: Papering Over Important Differences, Joanna Moncrieff, MD June 29, 2018
- Abolishment of forced treatment is an ethical imperative, P. Goetzsche MD, 6/17/16
- Forced treatment is torture, P. Breggin MD, 6/19/16
- Suicide in the Age of Prozac, By Robert Whitaker - August 6, 2018 https://www.madinamerica.com
- Robert Waldinger, Psychiatrist, psychoanalyst, Zen priest, Director of the Harvard Study of Adult Develpoment, one of the most comprehensive longitudinal studies in history. (https://www.ted.com/talks/robert_waldinger_what_makes_a_good_life_lessons_from_the_longest_study_on_happiness).