Psychiatrist, Ira Steinman, author of Treating the “Untreatable”: Healing in the Realms of Madness, shares a story of recovery on his blog. I’ve republished it here with his permission:
Thirty Years Later: Still CURED of Paranoid Schizophrenia: By Ira Steinman
I was on a radio show two years ago, talking about Treating the “Untreatable”: Healing in the Realms of Madness. Before the show began, the staff gave me an email. They had apparently read the content of the email, for they presented it to me in a hushed and nearly reverential way. It was a lovely email from a former patient, telling me how much I had helped her more than three decades earlier. I pondered and tried to get a fix on who it was.
Suddenly, it became clear to me. It was Lois the protagonist of Two Rats and the Extraterrestrial in TREATING. I hadn’t heard from her for more than 25 years. After the show, I contacted her. We talked and traded emails on a number of occasions over the intervening time.
Life was good for her. Sure, there had been difficulties, but she had negotiated them. She had reestablished contact with her children, had remarried, worked, lived happily with her new husband and even dealt with his death. She was involved in life and activities and the lives of her children and grandchildren. Most importantly, she had done this on the basis of the Intensive Psychotherapy we engaged in, vividly described in Treating the “Untreatable’. This previously often hospitalized woman, who was a “burnt out case,”loaded up on all kinds of antipsychotic medications by a number of psychiatrists, hospitals, half way houses and day care settings for seven years prior to seeing me, hadn’t taken any antipsychotics for over thirty years. Her antipsychotic medications were gradually titrated down as her delusions and hallucinations were understood and worked through. She had had none of the hallucinations and delusions she had before she came to see me, hallucinations and delusions that were readily comprehensible during the uncovering, exploratory work that we did.
It was a great pleasure for me to know that Lois had weathered the storms of her psychosis and her previously inept and stultifying treatment with the usual evidenced based therapies available at that time. It was an even greater pleasure to realize that the gains of our two and a half years of Intensive Psychotherapy had lasted over the intervening decades and that Lois had built a life for herself. Most importantly, it remains a deep pleasure to know that our Intensive Psychodynamic Psychotherapy led Lois out of the morass of psychosis and the oft repeated diagnosis of Paranoid Schizophrenia into a world where she leads a full life as a functioning person. For Lois and her Intensive Psychotherapy, the word CURE seems appropriate.
But how can schizophrenia be cured? Isn’t it a brain disease? How can talking change the brain?
Intensive Psychotherapy can be transformative. It was for Lois and it has been for others. How does it transform? By talking about and working through the patient’s own metaphor, concretized into hallucinations and delusions. My fingers typing are the result of brain reactions and chemicals. When a person is beset by his own thought productions and doesn’t recognize that they come from within, it is a small step to become either terrified or enraged or dissociated; or some combination of each. All of these reactions have a chemical substrate.
As issues are worked through, as hallucinations and delusions are metabolized psychologically, a person begins to calm. Brain chemistry, as Susan Vaughan describes in The Talking Cure changes in the neurotic person as issues get worked through. In the psychotic person, sometimes one gets lucky and understands the origin of psychotic thought, as was the case with Lois and others in Treating the “Untreatable. When this happens, there is calming and the ability to give up hallucinations, delusions and other forms of psychotic thinking. Often, antipsychotic medications can be titrated down and sometimes stopped as comprehension replaces terror.And of course, brain chemistry changes when someone is not constantly in a state of excitement and on alert.
So Lois got cured and Paranoid Schizophrenia was cured and Brain Chemistry Changed as Lois understood her issues and realized that what seemed to come from the outside, really came from within. And this has lasted over thirty years, with no antipsychotic medication.
Not bad for Intensive Talk Therapy of Psychosis.