This is an edited version of something I posted the first month I wrote this blog about a four years ago. I have posted on Soteria numerous times as it’s a very good and well documented example of recovery from “severe mental illness” without medications in a residential setting.
Many people share the concern over the use of neuroleptics/antipsychotics but feel at a loss about how to care for those who suffer severe forms of mental distress like psychosis or that which gets labeled schizophrenia. Recently I posted about a new documentary film by Daniel Mackler, Healing Homes. That program in Sweden is also in keeping with what Soteria did. There are many non-drug approaches to treating such distress but biopsychiatry has a long history of refusing to consider them.
I think the example of Soteria House and the programs it inspired are key here. Soteria House was a project that ran from 1971-1983. The staff cared for people who were diagnosed schizophrenic and compared outcomes with the local psychiatric hospital. It was a drug free rehabilitation. (drugs were used in just 3% of cases and only very temporarily)
It seems that most people who exhibit forms of psychosis would benefit from such care. Whether it’s labeled schizophrenic or bipolar or some combination thereof.
Soteria house was created for those diagnosed as schizophrenic, but it’s progenies have worked with all sort of people labeled “seriously mentally ill,” with similar startling results:
ABSTRACT: The author reviews the clinical and special social environmental data from the Soteria Project and its direct successors. Two random assignment studies of the Soteria model and its modification for long-term system clients reveal that roughly 85% to 90% of acute. and long-term clients deemed in need of acute hospitalization can be returned to the community without use of conventional hospital treatment. Soteria, designed as a drug free treatment environment, was as successful as anti-psychotic drug treatment in reducing psychotic symptoms in 6 weeks. In its modified form, in facilities called Crossing Place and McAuliffe House where so-called long-term “frequent flyers” were treated, alternative-treated subjects were found to be as clinically improved as hospital-treated patients, at considerably lower cost. Taken as a body of scientific evidence, it is clear that alternatives to acute psychiatric hospitalization are as, or more, effective than traditional hospital care in short-term reduction of psychopathology and longer- social adjustment. Data from the original drug-free, home-like, nonprofessionally staffed Soteria Project and its Bern, Switzerland, replication indicate that persons without extensive hospitalizations (less than 30 days)are especially responsive to the positive therapeutic effects of the well-defined, replicable Soteria-type special social environments. Reviews of other studies of diversion of persons deemed in need of hospitalization to “alternative” programs have consistently shown equivalent or better program clinical results, at lower cost, from alternatives. Despite these clinical and cost data, alternatives to psychiatric hospitalization have not been widely implemented, indicative of a remarkable gap between available evidence and clinical practice. J Nerv Ment Dis 187:142-149, 1999
More from the Soteria website:
Basically, the Soteria method can be characterized as the 24 hour a day application of interpersonal phenomenologic interventions by a nonprofessional staff, usually without neuroleptic drug treatment, in the context of a small, homelike, quiet, supportive, protective, and tolerant social environment. The core practice of interpersonal phenomenology focuses on the development of a nonintrusive, noncontrolling but actively empathetic relationship with the psychotic person without having to do anything explicitly therapeutic or controlling. In shorthand, it can be characterized as “being with,” “standing by attentively,” “trying to put your feet into the other person’s shoes,” or “being an LSD trip guide” (remember, this was the early 1970s in California). The aim is to develop, over time, a shared experience of the meaningfulness of the client’s individual social context-current and historical. Note, there were no therapeutic “sessions” at Soteria. However, a great deal of “therapy” took place there as staff worked gently to build bridges, over time, between individuals’ emotionally disorganized states to the life events that seemed to have precipitated their psychological disintegration. The context within the house was one of positive expectations that reorganization and reintegration would occur as a result of these seemingly minimalist interventions.
What is most remarkable about this is that the staff were not afraid of psychosis. Psychiatry is fraught with fear. Fear of that which is not understood, and so, psychosis must be suppressed and in so doing so begins the oppression of those labeled with mental illness. It’s all a slippery slope from there. It’s additionally interesting that the staff at Soteria, were largely non-professional and therefore not brainwashed by psychiatry and psychology in school. They therefore had much fewer negative assumptions about the people they were helping and instead made the positive assumption that recovery was possible, something most mental health professionals don’t truly entertain in most instances. In the mental health system today people are told that they need to learn how to be sick and take neuro toxic drugs for the rest of ones life. It’s hardly an empowering way to move forward with ones life.
In mainstream mental health these days, not just psychosis, but every less than pleasant feeling ends up medicated. We are all afraid of feeling. We are not taught to cope and we have the expectation that we should be “happy.” Normal causes of pain and suffering like grief and trauma are medicated instead of worked through. And natural alternatives are not even considered. This is in the truest sense inhumane. It is human to feel and yet we are more and more often told that “negative” emotions are a disease.
Psychiatry is often all about suppressing feelings rather than exploring their genesis.
We can instead choose to explore our histories and transform our lives. We need to make that a choice that is available to everyone. Right now it’s simply not a choice many people can afford to make since there is virtually no where to safely do it.
There are a few programs scattered throughout the world that continue to prove this sort of care is healing and restorative. I posted above the link about Healing Homes. And there are other programs too that report ongoing successes. Another one that has been discussed on this blog is Open Dialog, which is a therapeutic process. Here is an interview with a practicing therapist in Open Dialog.
If you’re interested in reading the book, Soteria: Through Madness to Deliverance you can buy it here.
For some other posts and videos on Soteria look here (the founder, Loren Mosher, talks about Soteria) and here for an interview with the original clinical director, Voyce Hendrix.