Note from CCHR:  This is a very interesting article, and reminds us of the movie A Beautiful Mind and the great disservice it did to Nobel prize winner John Nash, by completely altering the most remarkable element that led to his recovery— the fact he refused to continue taking psychiatric drugs, thereby changing the entire success of what Nash was able to accomplish—a drug free recovery. The film portrays Nash as taking “newer medications” at the time of winning his Nobel Prize, (which was false) thereby directly implying it was psychiatric drugs that cured him.  Nash, himself, says this is pure fiction; he hadn’t take psychiatric drugs for 24 years and stated that he willed his own recovery.   Why invent a fictitious pharma-friendly ending when the truth was so much more inspiring? The fact that the screenwriter’s mother was a psychiatrist may have had something to do with the film’s distortion, Nash said. The point is that psychiatry has long refused to admit psychiatric disorders are not medical conditions, and have vehemently suppressed workable non-drug treatments to overcome mental difficulties, even of the severity experienced by John Nash.  In the 1970’s, psychiatrist Loren Mosher, Chief of Schizophrenic Research for the National Institute of Mental Health, (who openly stated the diagnoses of schizophrenia had no medical merit), established a drug-free program — Soteria House — for patients diagnosed schizophrenic, “The idea was that schizophrenia can often be overcome with the help of meaningful relationships, rather than with drugs, and such treatment would eventually lead to unquestionable healthier lives,” Mosher said. Between 85 percent and 90 percent of the acute and long-term clients were able to return to the community without use of conventional hospital treatment.

As a teenager Gail Hornstein developed a fascination with first-person accounts of mental illness, and in the decades since, she has collected more than seven hundred patient memoirs, autobiographies, and witness testimonies. She likens them to survivor accounts or slave narratives, with patients struggling against the psychiatric system to make their voices heard.

According to the National Institute of Mental Health, approximately one in four Americans suffers from a diagnosable mental disorder. Our society has gone further than any other in classifying unwanted behaviors and emotions as diseases demanding medical — and often pharmaceutical — treatment.

Hornstein, now a Mount Holyoke College professor of psychology, questions whether this labeling benefits those being labeled. She also rejects the idea that psychiatric patients, however severe their symptoms, have a physical disease. Even schizophrenia and other types of psychosis, Hornstein suggests, can result from trauma, abuse, and oppression. She offers a popular course for psychology majors in which they read only books by patients, and she urges a more open-minded inquiry into what causes mental illness and how people get better.

Frisch: You express enormous empathy for those labeled “mentally ill,” yet you avoid romanticizing their lives. How do you walk this fine line?

Hornstein: I try to understand people as they understand themselves. If you ask them what their experience is or read their own accounts, you’ll find they can be articulate and psychologically sophisticated. Even people who lack formal education can offer highly nuanced descriptions of their emotional lives. I’ve adopted a phrase from my uk colleagues: “experts of their own experience.” This view helps me avoid either romanticizing their experience — seeing it in a more positive way than they do — or seeing it only as a tragedy with no redemptive qualities.

Emotional distress is highly individualized, and we shouldn’t come to any general conclusions about it. There are people who feel they’ve learned something profound from the experience of hearing voices, but there are plenty of others who are frightened and just want the voices to go away. One woman said to me, “If I could wake up tomorrow and not hear any voices, I would open up a bottle of champagne.” Yet she’d discovered the strength to get through it.

Frisch: Why do you feel so strongly about avoiding the phrase “mental illness”?

Hornstein: The term “mental illness” is heavily charged, politicized, and ambiguous. I prefer to talk about “anomalous experiences,” “extreme emotions,” and “emotional distress.” The main reason I don’t use medical language is that people who are suffering often don’t find it very helpful. No one experiences “schizophrenia” — that’s just a technical name for a lot of complicated feelings.

People who have been taught that “mental illnesses are brain diseases” see psychiatric patients as dangerous and unlikely to recover. And those in crisis are often understandably reluctant to consult mental-health professionals, because the stigma of mental illness is so severe: it’s possible to lose your job, your home, and your family as a consequence of being diagnosed with a mental illness. In cultures that take a social view of emotional distress, by contrast, people more readily seek help because they aren’t as likely to be ostracized and are assumed to be capable of full recovery.

The World Health Organization did an international study comparing outcomes for patients diagnosed with schizophrenia in “developed” countries — including the U.S., the United Kingdom, Denmark, and others — and in “developing” countries such as Colombia, Nigeria, and India. To their astonishment, they found that outcomes were much better in the developing countries. As often happens when a study produces unexpected results, the findings weren’t believed at first. So the study was repeated a few years later with a more stringent definition of what constituted improvement for the patients. The results were the same.

Two hypotheses have been put forward to explain these findings. One is that developing countries don’t use medications over the long term because they can’t afford it. Without long-term medication, patients don’t become chronically disabled. The other hypothesis is that people in developing countries are more likely to be cared for at home and be a part of their community, rather than being isolated or sent away to a hospital, and this helps them recover.

Frisch: How does what is commonly called “mental illness” differ from physical disease?

Hornstein: In psychiatry mental illness is a metaphor imposed on people’s behavior. There aren’t any physical methods of diagnosing a mental illness: There’s no blood test. There’s no mri. So-called mental illnesses are diagnosed on the basis of behavior. The “chemical-imbalance” theory was invented by the marketing departments of drug companies to try to convince doctors to prescribe their products. Some doctors say depression is just like diabetes: you have an imbalance of a neurotransmitter, the way a diabetic might need more or less insulin, and this drug will restore your balance. But with diabetes it’s possible to measure the amount of sugar and insulin in your blood. We know what a balanced level is. No doctor who has given anyone an antidepressant has ever measured the level of a neurotransmitter in the patient’s body. There is no independent means by which to tell if someone has a “chemical imbalance.”

Frisch: Do any mental illnesses have a known physiological basis?

Hornstein: The initial symptoms of Huntington’s disease resemble the symptoms of mental illness. When folk singer Woody Guthrie first manifested Huntington’s disease, he was sent to a psychiatric hospital. Similarly people in the early stages of brain cancer may behave in anomalous ways. If you don’t know they have cancer, you might think they’re having a psychiatric breakdown. But once they get a cat scan, you can see the brain tumor. You can’t see schizophrenia.

Frisch: I have always taken it for granted that only mystics or crazy people hear voices, but you suggest that it’s more common than we think.

Hornstein: Many people who hear voices never attract the attention of the psychiatric system. Estimates are that 4 percent of the uk population hears voices — approximately the same percent that has asthma. In Western society we most often associate hearing voices with illness. If we lived in a part of the world that was given to greater religiosity, unusual psychological experiences might be labeled as divine gifts. All the major religions of the world include figures who heard voices or had other anomalous psychological experiences. If the pastor in an Evangelical Christian church tells the congregation, “God spoke to me last night,” no one in that church thinks he has lost his mind.

Whether a phenomenon is considered “abnormal” or not depends on the circumstances, the person’s suffering, the reactions of others, and many more factors. One of the main goals of my book Agnes’s Jacket is to give readers the opportunity to learn about people who have unusual experiences and to encourage them to tolerate a wider range of behavior in themselves and others.

Read the rest of the article here: http://www.thesunmagazine.org/issues/427/the_voices_inside_their_heads