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My blackboard quotes must be getting up
someone's nose.
They keep getting defaced. |
Extract from Robert Whitaker's Anatomy of an Epidemic
“The third study was led by Loren
Mosher, head of schizophrenia at the NIMH [National Institute of
Mental Health, USA], Although he may have been the nation's top
schizophrenia doctor at the time, his vision of the illness was at
odds with many of his peers, who had come to think that
schizophrenics suffered from a “broken brain.”
He believed that psychosis could arise from emotional and inner trauma and, in its own way, could be a coping mechanism. As such, he believed there was the possibility that people could grapple with their hallucinations and delusions, struggle through a schizophrenic break, and regain their sanity.
And if that was so, he reasoned that if he provided newly psychotic patients with a safe house, one staffed by people who had an evident empathy for others and who wouldn't be frightened by strange behaviour, many would get well, even though they weren't treated with antipsychotics.
“I thought that sincere human involvement and understanding was critical to healing interactions,” he said. “The idea was to treat people as people, as human beings, with dignity and respect.”
The twelve-room Victorian house he opened in Santa Clara, California, in 1971 could shelter six patients at a time. He called it Soteria House, and eventually he started a second home as well, Emanon. All told, the Soteria Project ran for twelve years, with eighty-two patients treated at the two homes.
As early as 1974, Mosher started reporting that his Soteria patients were faring better than a matched cohort of patients being treated conventionally with drugs at a hospital, and in 1979, he announced his two-year results.
At the end of six weeks, psychotic symptoms had abated as much in his Soteria patients as in the hospitalised patients, and at the end of two years, the Soteria patients had “lower psychopathology scores, fewer [hospital] readmissions, and better global adjustment."
He believed that psychosis could arise from emotional and inner trauma and, in its own way, could be a coping mechanism. As such, he believed there was the possibility that people could grapple with their hallucinations and delusions, struggle through a schizophrenic break, and regain their sanity.
And if that was so, he reasoned that if he provided newly psychotic patients with a safe house, one staffed by people who had an evident empathy for others and who wouldn't be frightened by strange behaviour, many would get well, even though they weren't treated with antipsychotics.
“I thought that sincere human involvement and understanding was critical to healing interactions,” he said. “The idea was to treat people as people, as human beings, with dignity and respect.”
The twelve-room Victorian house he opened in Santa Clara, California, in 1971 could shelter six patients at a time. He called it Soteria House, and eventually he started a second home as well, Emanon. All told, the Soteria Project ran for twelve years, with eighty-two patients treated at the two homes.
As early as 1974, Mosher started reporting that his Soteria patients were faring better than a matched cohort of patients being treated conventionally with drugs at a hospital, and in 1979, he announced his two-year results.
At the end of six weeks, psychotic symptoms had abated as much in his Soteria patients as in the hospitalised patients, and at the end of two years, the Soteria patients had “lower psychopathology scores, fewer [hospital] readmissions, and better global adjustment."
Later, he and John Bola, an assistant
proffessor at the University of Southern California, reported on
their medication use: Forty-two percent of the Soteria patients had
never been exposed to drugs, 39 percent had used them on a temporary
basis, and only 19 percent had needed them throughout the two-year
follow-up.
“Contrary to popular views, minimal use of antipsychotic medications combined with specially designed psychosocial intervention for patients newly identified with schizophrenia spectrum disorder is not harmful but appears to be advantageous,” Mosher and Bola wrote. “We think that the balance of risks and benefits associated with the common practice of medicating nearly all early episodes of psychosis should be re-examined.”
Three NIHM-funded studies, and all pointed to the same conclusion. Perhaps 50 percent of newly diagnosed schizophrenia patients, if treated without antipsychotics, would recover and stay well through lengthy follow-up periods. Only a minority of patients seemed to need to take the drugs continuously.
The “revolving door” syndrome that had become so familiar was due in large part to the drugs, even though, in clinical trials, the drugs had proven to be effective in knocking down psychotic symptoms.
Carpenter and McGlashan neatly summarised the scientific conundrum that psychiatry now faced:
“There is no question that, once patients are placed on medication, they are less vulnerable to relapse if maintained on neuroleptics. But what if these patients had never been treated with drugs to begin with?...We raise the possibility that antipsychotic medication may make schizophrenic patients more vulnerable to future relapse than would be the case in the natural course of the illness.”
And if that was so, these drugs were increasing the likelihood that a person who suffered a psychotic break would become chronically ill.”
~Robert Whitaker, 'Anatomy of an Epidemic'
“Contrary to popular views, minimal use of antipsychotic medications combined with specially designed psychosocial intervention for patients newly identified with schizophrenia spectrum disorder is not harmful but appears to be advantageous,” Mosher and Bola wrote. “We think that the balance of risks and benefits associated with the common practice of medicating nearly all early episodes of psychosis should be re-examined.”
Three NIHM-funded studies, and all pointed to the same conclusion. Perhaps 50 percent of newly diagnosed schizophrenia patients, if treated without antipsychotics, would recover and stay well through lengthy follow-up periods. Only a minority of patients seemed to need to take the drugs continuously.
The “revolving door” syndrome that had become so familiar was due in large part to the drugs, even though, in clinical trials, the drugs had proven to be effective in knocking down psychotic symptoms.
Carpenter and McGlashan neatly summarised the scientific conundrum that psychiatry now faced:
“There is no question that, once patients are placed on medication, they are less vulnerable to relapse if maintained on neuroleptics. But what if these patients had never been treated with drugs to begin with?...We raise the possibility that antipsychotic medication may make schizophrenic patients more vulnerable to future relapse than would be the case in the natural course of the illness.”
And if that was so, these drugs were increasing the likelihood that a person who suffered a psychotic break would become chronically ill.”
~Robert Whitaker, 'Anatomy of an Epidemic'
Robert Whitaker is an American journalist and author, writing primarily about medicine, science, and history.
https://en.wikipedia.org/wiki/Robert_Whitaker_(author)
Loren Richard Mosher (September 3, 1933, Monterey, California – July 10, 2004, Berlin) was an American psychiatrist, clinical professor of psychiatry, expert on schizophrenia and the chief of the Center for Studies of Schizophrenia in the National Institute of Mental Health (1968–1980).
https://en.wikipedia.org/wiki/Loren_Mosher
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