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Not Yet (These Nights Go On and On and On)

Several blogs back (I don’t know which one and I’m not going to go back looking for it) somebody made a comment about my use of music videos in my blogs. I do read every comment that comes in but I rarely remember them. Yet this one stands out to me, months later. I don’t remember it word for word, but it was a snide remark, the commenter stating something to the effect using music to express emotions is something only high school kids do.

 

I suppose the primary reason it stuck in my mind was because I found it funny. I didn’t reply because I’d never really thought about why I do it until then and I didn’t have an answer. Obviously, it is conscious decision on my part, in the sense that I try to match the song to the content of my blog, but I’d never really asked myself why I do it. I have no way to track how many readers watch the videos but I would venture to guess the number is fairly small. It is, I would imagine, hard to sit and take the emotional sledgehammer that comes with reading about our life and then click on the video at the end. It is kind of having your head crushed and then asked if you’d like to go see a movie. No, thank you. I’m still trying to process what I just read. I’m not really in the mood for Coldplay.

 

Which is part of why I do it. The videos are the come down, a metaphorical version of the hypnotist counting back from ten to one and telling you when you hear the number one you will wake up, refreshed and rejuvenated.

 

But mainly, like high school kids used to do on MySpace, I do it for me. It’s my rejuvenation. I have to give myself a way out. This is not true of all my blogs, but some of them, during the writing process, the emotions start to come. As I write, I feel them build and I feel myself start to break. There are some blogs where to fully tell the tale I have to go back into a place I really don’t want to go. I have to feel what I don’t want to feel, feelings that if they took over would destroy my ability to function. By the time I come to those blogs, I am emotionally spent. I turn to the music videos to bring me back out.

 

Quite often in my blogs, I do what I am doing right now, which is avoiding my emotions. I stay shallow as a survival instinct. I am well aware that the most powerful blogs are the ones where I rip myself open but, quite frankly, that is just not something I can do on a regular basis.

 

Thanks to my mother, I was introduced to psychology at a very young age. Some parents are alcoholics. Some are drug addicts. Mine was an amateur shrink. Psychology, hers, my father’s, and mine, was her addiction. And addiction, by its nature, gradually tears away any aspect of your life that is not the addiction, until there is nothing left but the addiction and you are simply the vessel for it. People are generally drawn to psychology because they want answers: answers about why they are the way they are. Really, it’s very similar to religion. Humans turned to the supernatural to explain why the world around them was the way it was. Eventually, those supernatural beliefs formalized and ritualized into a religion.

 

The difference between religion and psychology is that religion, at least originally, sought to explain the causes of events around us. Psychology, at least originally, sought to explain the causes of events we create. Psychology is religion turned inward. It’s looking for the devil within instead of looking for the Devil without.

 

Yes, I am still avoiding my emotions. It is far easier to pontificate on humanity than actually feel emotions. Bear with me. I have to work up to it.

 

The problem is that if you go looking for the Devil, you’ll eventually find him.

 

It’s interesting how it is so much easier to find the things that are wrong with you than the things that are right.

 

Medicine was born out of looking for the devil. In fact, in its earliest incarnations, that is exactly what doctors were doing. Some of that still survives to this day. There are MDs in every corner of the world (although they aren’t always easy to get to) but in many parts of the world, locals would rather go to the witch doctor than an MD. Even here in the United States or elsewhere in the West, there are plenty of people who turn to various healers with a certificate from the Learning Annex that says they are qualified in Chinese herbs or Reiki energy. It is not my intention to disparage these people. I have friends who claim to be Reiki healers. But let’s face facts. They’re witch doctors. There’s nothing wrong with being a witch doctor. If you are one, you are part of an ancient tradition that goes back to the earliest human tribes.

 

And like I said, medicine was born from that same tradition. Medicine gave birth to psychiatry in the late 19th Century. Yes, psychiatrists prescribe more medications now than they did in the past, but the rise in prescription rates of psychiatric medications has been no more rapid than the rise in prescribed medications for other illnesses.

 

This is not some grand conspiracy. It is because the drugs didn’t exist.

 

What exactly do you think doctors did for you if you got strep throat or pneumonia in 1890 or even 1920?

 

Answer: They watched you either beat it on your own or they watch you die. Generally, it was the latter.

 

There wasn’t much else they could do for you. Their training was in how to diagnose. They knew the mechanism of how the infection was killing you but not how to cure it. Treatment was a combination of various elixirs and potions to treat symptoms combined with prayer. “We’ve done all we can. Now we just have to hope for the best,” was a common refrain from doctors to parents of sick children right through until the 1960s.

 

Two things happened that revolutionized the treatment of illness. The first was the discovery and mass production of antibiotics. It might surprise you to know that there were those who distrusted antibiotics and believed people shouldn’t take them decades before anyone made a stink about kids taking Ritalin or Abilify.

 

The second revolution was the development of vaccines, particularly against smallpox, polio, whooping cough, and yes, mumps, measles, and German Measles (now known as “Rubella”).

 

For those of you who don’t vaccinate your children, why exactly do you think people live longer today? Diet? Bullshit. Our diet is far worse today than it was for our ancestors. We have a high fat, high sugar diet. They had a high protein, low fat, low sugar diet. People are quitting smoking and drinking? Also bullshit. Sure, stopping these things reduce your likelihood of liver disease, kidney disease, heart disease, lung cancer, emphysema, etc, etc, but those were things that got most people at the end of their lives. A man in 1930 dropped dead from a massive heart attack at forty for the same reason a man drops dead of a massive heart attack at forty in 2011: there was a genetic abnormality.

 

The primary reason we live longer today is because we have been inoculated against the things that often killed or weakened us. For those who don’t vaccinate your children for MMR, it’s too bad you can’t too many mothers left alive who had to watch their children die from mumps, measles, or rubella.

 

By the way, this is one area Susan and I disagree on. Susan is not sure about the role of vaccines in autism because Bodhi was developing normally (or so she believes) until he got his MMR at two. I see this as the error of “cause and effect:” just because “B” came after “A” does not, in and of itself, mean that “A” caused “B.”

 

Which brings me back to psychology. The first generation of psychologists were medical doctors. The second generation were also MDs but studied psychiatry in a time when psychotropic medications were not yet available. It was this lack of pharmacology in early to mid 20th Century psychiatry that led to the division of psychiatry and psychology into distinct fields. I get this. In 1950, unless you felt comfortable giving lobotomies, psychiatry must have seemed fruitless in terms of reducing a patient’s suffering. In that world, I would have preferred psychology as well.

 

But something happened. While mid-century psychiatrists were focused on brain biology and what connections they could cut to improve social behavior, mid century psychologists, perhaps horrified by the apparent lack of concern for the rights of psychiatric patients, retreated from psychiatry and the focus on the brain. The end result was that by 1965, just as Thorazine was becoming available, psychologists had split “the mind” from the biological brain, creating a division that still exists to this day. Psychiatry focuses on the brain and psychology focuses on the “mind.”

This is interesting because this has never happened in any other field of medicine. Cardiologists never divided their specialization into the physical heart and “the soul,” even after the first heart transplant was done using an artificial heart. There was no debate over whether those first heart transplant recipients were fully human anymore. The field didn’t divide when a baboon heart was transplanted into a little girl. No one felt she had lost her humanity. That was because all her parents cared about was keeping her alive.

 

Psychiatry doesn’t destroy lives. Psychiatry does what all medicine tries to do, which is save lives. And, like all areas of medicine, it doesn’t always succeed. To this day, parents with children who must undergo organ transplants must also face the reality that the treatment can kill. The drugs necessary to suppress the body’s natural immune response to a foreign body can lead to secondary illnesses that also require treatment.

 

But when you are told your child needs a heart transplant, no parent thinks about that. All they think about is they want their child alive. Statistically, their child will still have a shorter lifespan. Statistically, their child is more likely to die from infections that are harmless to most of us. Statistically, their child will never be who they were before.

 

But no parent ever struggles with that decision. They will pay any price to keep their child alive longer, even if they are not the only ones who will have to pay that price. The child will pay that price, too.

 

But parents do it because it is their biological imperative: as parents, we are biologically driven (in the absence of an overriding mental illness or personality disorder) to preserve the lives of our children at any cost. This imperative is so strong we will kill for it without a second thought, let alone injure ourselves.

It is so strong, like the imperative to eat, the imperative to drink, the imperative to have sex, all base instincts of humans, that its absence can only be attributed to a biological failure within the brain’s neurochemistry. All the trauma and abuse in the world cannot take it away (although it can minimize the desire for sex and food). Don’t believe me?

 

Ask Jaycee Dugard.

 

Jaycee Dugard is a hell of a mother. She would have killed to protect her children, even though they were the product of being raped by Philip Garrido who kidnapped her and held her for 18 years. Dugard never let Garrido lay a hand on her two daughters, even if it meant she had endure more of his sexual violence.

 

Now that is a heroic sacrifice for your children. Nothing I have done or ever will do could compare to that. My sacrifices are very, very mild in comparison.

 

Dugard’s psyche “her mind,” was so shattered by her ordeal that it will probably take her the rest of her life to recover, if she ever does. But her brain always did and always will defend her children.

 

It would appear that physical human brain, even though we understand so little about it, is stronger than “the mind.”

 

Which brings me back to psychology. Generally, you go to a psychologist because you don’t “feel” right. The psychologist and you then go looking for the source of this discomfort, looking inside, starting with problem “Z” and trying to trace it all the way back to cause “A.”

 

In other words, you go looking for the devil in you.

 

But the human brain is not simple, and tracing “Z” back to “A” is just too simple. It’s not like you were born a blank slate. However much you may want to believe the environment created you, that’s a cop out. Your environment and your response to it SHAPED you, but it did not create you. “A” is not where your pain began. “A” happened before you were born. “A” happened at the moment of your conception, when chains of DNA began to form into long strings of genes, which in turn folded up into your chromosomes.

 

That’s not to say shit didn’t happen after that. Life is tough.

 

But it didn’t make “Z” either, because you’re not at “Z,” not unless you are reading this from your deathbed. I don’t know what letter you are. That’s up to you. Maybe you’re at “T,” or “P,” or “M.”

 

Where-ever you are, of course your environment shaped part of where you are today, but it wasn’t in chronological order. Maybe, right now, at “M,” you feel pain. Chances are there is not one single previous letter that caused that pain. Sure you got hurt at “D” and “G” and “L,” and collectively those mix with “A” and every other letter to make you feel what you feel today, but it wasn’t any one of those. And none of those are going to kill you because if they were going to you wouldn’t have made it to “M.”

 

You are stronger than you think you are. That is what I tell everybody who says to me, “I don’t know how I could do what you do.”

 

You just do.

 

I don’t know how Dugard survived what she survived. She just did.

 

You do what ya gotta do to get from one day to the next. That’s life.

 

I think perhaps one of the reasons that Jani’s diagnosis bothers some people is because they think a diagnosis of schizophrenia is “Z.”

 

It isn’t. Jani’s not at “Z.” She is a long way from “Z.” Three years ago, she was moving rapidly toward “Z.” Slowly, gradually, we slowed it down. Then, slowly, gradually, she turned it back. She “reset” to the letter she was when she became acute. Now she is moving through the alphabet again, but she is doing it on her own terms. That’s what the medications did for her.

 

I don’t know where Bodhi is, but I do know Bodhi is also a long way from “Z.” Right now it is autism. Maybe it will stay that. Maybe it won’t. But either way, Bodhi has a lot of the alphabet left to go.

 

Psychology and psychiatry are finally, after almost a century apart, coming back together. They are coming back together because neither side has all the answers. Who we are is not purely biochemical and it is not purely environmental factors. It some combination we lack the ability to fathom. “The Mind” is not totally separate from the biological brain. Yet, I cannot say for certain that “The Mind” is a socio-cultural concept, either. At any length, “The Mind” is you, which includes your brain. Or is that your brain includes “the Mind?”

 

Maybe it is just easier to think of ourselves as independent of our biology, more than just a sequence of DNA. I get that. We want to “be.” We want to “exist.” We want to say, “I think; therefore I am.” We want to be more than the sum of our parts. That is our gift as humans, to conceive of something greater than us, to conceive of lands beyond the horizon of our vision, to conceive of worlds we cannot see beyond the immense darkness of space.

 

The two most important words in human language is “I am…”

 

Finally, back to the music videos. I have another reason I include them.

 

Yes, it is very “high school.” I don’t deny that. But it’s also how I can relate to Jani. It is our language.

 

There was a time when my teaching her was our language. I still can teach her but not like in the old days. Things that used to fascinate her don’t hold her interest anymore. She doesn’t love to learn like she once did. That is gone. Will it ever come back? I don’t know. We’re not to “Z” yet. But that loss has been hard for me.

 

There was a time when “silliness” was our language, and sometimes it still is. But it gets hard to be silly when she is constantly talking to me about “friends.” She will tell me what they say and then say, “Say it,” wanting me to repeat it back to her. Most of the time I try. Lord, I try. But when Bodhi is screaming or my mind is on errands we need to run, it gets hard. Bodhi needs so much more and Jani still needs so much. Last week Susan and I had dental appointments. We only go once a year.  We did the appointments back to back. I took the kids for Susan’s appointment, taking them to Page Museum at the La Brea Tar Pits. We had a good time, although Bodhi had no interest in the animatronic Wooly Mammoths and Ground Sloths fighting off a Sabre-Tooth Cat. He kept pulling against me, screaming to go back to read books in a little library section he had seen. Eventually, he broke free and ran back. I chased after him, hearing Jani tell me that she wanted to see something else and me trying to explain over my shoulder, forty yards down the concourse, that I have to stay with Bodhi and telling her she needs to come with me and praying, as I am running, that when I finally catch Bodhi and look back over my shoulder, she will be there.

 

She always is.

 

Anyway, while Bodhi was looking at books, I could see Jani getting bored. She started throwing stuffed animals and trying to tear the books. So I picked up a stuffed animal of a sabre-tooth cat and started talking to it, saying, “You used to eat us.”

 

“Well, you were so tasty,” I made it reply. Out of the corner of my eye, I see Jani smiling and rubbing her hands together.

 

“But now you’re a sweet kitty.”

 

“I know! Once we were feared predators and now we use litterboxes? What happened?”

 

“Didn’t see that one coming, did you?”

 

“Not at all. I used to eat you humans for lunch.”

 

“But who’s in the Tar Pits now, huh? It’s not us! It’s you!” Jani laughs as I kiss the stuffed sabre-tooth cat on its nose while playfully mocking it for being extinct.

 

But those moments are rare. I dropped Jani and Bodhi off with Susan to go for my turn in the dentist chair. Fifteen minutes later I get a call that Jani doesn’t want to go to school.

 

I was upset. Fifteen minutes ago she was fine. I can’t even get my fucking teeth scraped without Jani withdrawing or becoming mildly psychotic (disordered thinking but no violence).

 

I am not going to lie. I get bitter as hell sometimes. I couldn’t take Susan out for her birthday. It is never just the two of us. When Jani is around there is no break because she cannot self-entertain herself at all. She needs to talk all the time, usually about her “imaginary friends.”

 

I used to think I could deal with it, but there are times now where I have to tell Jani to give me a break from her world. She looks down and I sense the sadness in her and it rips me apart, but I can’t help it. There is only so long I can pretend to care about things I can’t see.

 

Then she will look up and say, “Okay.” I will watch her make a few abortive attempts to leave, like she is trying to force herself to go. “I’ll go play with Bodhi.”

 

She will go over to Bodhi and sit down next to him. She taps him on the back. “Good baby,” she will say, looking down at him. I can see it in her eyes, the wish he would talk back to her. She rubs his back, again as if forcing herself to, not because she is angry but because she wants to be a good big sister, even though she knows it is beyond her means. Then she kisses him on his head and comes back over to me.

 

Still desperate for a few moments, I ignore her. She wanders around the living room, looking up and around.

 

Always I know, you’ll be at my show…

 

I look up from the computer. Jani is singing softly to herself.

 

“…watching, waiting, commiserating.”

 

I’m stunned. “Jani, is that Blink-182?”

 

Jani turns to me and nods. She starts again….”All the small things…

 

We’ve heard that song on the radio a thousand times. I never thought she paid attention and now here she is, singing “All the Small Things” lyrics off the top of her head.

 

I never liked Blink 182 back then. I thought their commercialized pop-punk was annoying.

 

Now I am a Blink 182 fan.

 

Every song that comes on the radio, Jani asks me what it is.

 

“What’s that?”

 

“’Losing My Religion’ REM.”

“’The Cave’ Mumford and Sons.”

“’I Wanna Be Sedated’ by the Ramones”

“’Surrender’ by Cheap Trick. You know they’re huge in Japan.”

“’Don’t Stop Believing’ by Journey. They’re from San Francisco.”

“’Down on the Corner,’ Creedence Clearwater Revival.”

“’Riding on the Metro,’ by Berlin, but they’re not actually from Berlin. They’re from here.”

 

Everyday she surprises me singing a song she heard on the radio. She picks up lyrics quickly. Her favorite is still Florence and the Machine. She waits impatiently for “Dog Days” or “Shake it Off.”

 

“And it’s hard to dance with the devil on your back, so shake him off…”

 

Good advice, Florence.

 

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26 comments on “Not Yet (These Nights Go On and On and On)

  1. Micheal, you are incorrect on the origins of psychiatry and psychology. The two, initially, were not related — they were entirely separate. They still, for the most part, are.

    First, it is important to understand that early psychologist were not clinical. That would come much later and, in fact, the majority are still not today. Psychology is the study of the mind and its behavior and — not abnormal behavior or mental states, per se. To understand what Psychology is and was think, for example, of Pavlov’s dog or Skinner’s Box. The field, furthermore, has been around for centuries and developed entirely separate from any field of medicine. As already stated, the intersection is a fairly new thing. Summarized point: Psychology is a (social) science. Psychiatry is a medical specialty. They were always separate. They were never one.

    On the other hand, psychiatry, as a medical specificity, has its start around the middle of the nineteenth century. It is worth noting, however, that mental illness has been dealt with by medicine since medicine began. Hippocrates, for example, wrote extensively on mental illness, theorizing that emotional disturbance was the result of physiological imbalance; the oldest manuals we have on mental illness date back to ancient Greece. Ancient Islamic physicians also wrote extensively on the subject, building “specialist hospitals” as early as 705 AD. Most of these physicians supported a physiological model. In more modern times, some of the greatest minds of medicine have speculated on the origin of psychiatric disorders. Harvey Cushing MD, for example, was published on the topic — he, of course, is most known as the Father of Neurosurgery.

    Despite the above, most still went to religious/faith healers. It took awhile for this trend to turn and, as you accurately pointed out, it still has not in many parts of the world. Physicians involved in International Medical work are still trying to figure out how to approach these witch doctors. With their enhanced understanding of the local culture and religion, some have had success in helping the afflicted. The vast majority, however, do not only slow or prevent recovery; but pose a health risk to the patient. They are known to, for example, slash open psychotic patients stomachs’ to help “free the demons”, give fatal mixtures of herbs and leave patients chained up for so long that their limbs atrophy and kept in sheds for so long their vision deteriorates to the point of blindness.

    Getting back to psychiatry, however, the field slowly began to move away from the ideas of biological psychiatry. Psychoanalysis, in particular, became popular (Frued, by the way, was a Neurologist). An often forgotten fact is that the most famous psychotherapists were psychiatrists. Even in more modern times this is true. Cognitive Behavioral Therapy, for example, was created by an MD (who is still alive and researching). Dialectal Behavioral Therapy is the only therapy that was really created by a PhD.

    Emil Kraepelin — a physician — is truly the father of modern biological psychiatry. He was around the same time as Frued; however, it took the end of the psychoanalysis craze to die down before his work truly came to light. This craze ended due to criticism within the field.

    Anti-psychiatry and deinstitutionalization were patient-driven and law-driven (in particular, see O’Connor v Donaldson), not professional driven.

    Psychiatry and psychology, furthermore, are not coming together again; they were never related. They are separate fields. Psychiatry is simply swinging back from the other end of the pendulum to a middle ground that includes biological and social psychiatry.

    Note from Michael: Thank you for the extensive historical background. I appreciate it. You clearly know more about the history of both areas better than me. I saw them as coming back together because of the decline of psycho-analysis (which has never been proven as clinically effective).

  2. Micheal, my other criticism to your post comes from your disregard of environmental influence. You criticize those who only take into account life experience, yet you commit the same fallacy by stating that only genetics matter and that, while life does suck, who you are was already written in your genetics. Neither is true.

    The reality lies somewhere in the middle. Your genetics count for a lot, certainly; however, so does what happens to you. As an example, many studies suggest a link between trauma and all forms of mental illness, from Major Depressive Disorder to Psychosis. Some disorders, such as Borderline Personality Disorder, are strongly linked to insecure attachment and, in fact, one of the less-known, yet still very successful therapies for the disorder is entirely based upon building a secure attachment with the therapist (to help develop the skills that were not learned with the original, insecure one). Non-secure attachment patterns have, furthermore, been linked with a host of issues — chaotic interpersonal relationships, inability to self-regulate, etc. There are some disorders, such as Reactive Attachment Disorder, PTSD and Complex PTSD that are 100% based upon trauma. etc. Stress in utero is linked to the development of mental illness in a fetus.

    The reality is that the biggest predictor of future mental illness is a combination of genetics and personal life situations. For some, genetics may be the only or primary factor. For others, it is the opposite. For most, it is a mix.

    Note from Michael: I didn’t think I was suggesting that environmental factors played no roll. Yes, obviously I see genetics as the primary factor (and fully admit I have a natural bias toward genetics) but I thought I was clear that environment also contributes to who we are. Appreciate the discussion.

  3. I have always felt that your videos were an excellent closing. It makes you real,I wonder why it is considered “high school” to relate music with feelings, I thought that was what music was all about. It can bring you out of a fog, express in words and rhythm what you’ve been feeling and are unable to communicate, music is a continuation of emotion.
    I may not be able to understand what you feel and experience on a daily basis, but when you share a song that you relate to an experience, I can feel the song, I can relate to you based on our mutual experience through that song. When I hear the song later, I will remember you and your family and how no matter who we are music can be a shared link.
    I saw Death Cab a few months back, when they played You are a Tourist I immediately thought of you and Jani sharing this song. I always do.

  4. I am a strong supporter of science and believe firmly that the MMR vaccine does not cause autism (correlation does not equal causation). A lot of parents dont notice the early signs of auto that begin around infancy because they don’t want to and although you guys already knew about the signs because of your struggle with jani it’s possible you might have brushed them off because of not wanting to believe that bodhi could be like his sister. Also because autism affects developmental skills most symptoms aret noticed until children begin develop entomb social skills which the disorder mainly affects

    Note from Michael: I agree. Science is not perfect but it is at least trying to find answers and not resting on dogmatic beliefs. It is when we are convinced we know something that we are lost.

  5. I am a strong supporter of science and believe firmly that the MMR vaccine does not cause autism (correlation does not equal causation). A lot of parents dont notice the early signs of auto that begin around infancy because they don’t want to and although you guys already knew about the signs because of your struggle with jani it’s possible you might have brushed them off because of not wanting to believe that bodhi could be like his sister. Also because autism affects developmental skills most symptoms aret noticed until children begin develop entomb social skills which the disorder mainly affects

  6. I am a strong supporter of science and believe firmly that the MMR vaccine does not cause autism (correlation does not equal causation). A lot of parents dont notice the early signs of auto that begin around infancy because they don’t want to and although you guys already knew about the signs because of your struggle with jani it’s possible you might have brushed them off because of not wanting to believe that bodhi could be like his sister. Also because autism affects developmental skills most symptoms aret noticed until children begin develop entomb social skills which the disorder mainly affects

  7. I love your blogs, Michael. They are so well written, and your prose is emotional, yet much grounded on a mix of facts and opinions. I think Psychiatry should be used for severe mental illnesses, and Psychology should be used for mild-to-moderate mental illnesses. Schizophrenia is said to be multfactorial–that is, there are many genes that are thought to be causative of this (once misunderstood) illness. Eri is correct in mentioning the fact that Emil Kraepelin–who was a German Physician– described mental illness in his written works. Emil Kraepelin called Schizophrenia–Dementia Praecox–however that term is now outdated, and the illness is now, eventually called Schizophrenia. Anyway, to get back to my point, Schizohphrenia has cognitive symptoms that interfere with functioning, through deficits in the same neurocircuitries as fronto-temporal dementai–however, I am not saying that these two conditions are the same, however , what I am trying to say is that the conditions have a strong genetic basis. To get back to Eri’s point, psychological factors have a say in mental illnesses, however, and a big however, is that schizophrenia has more genetic causes than it does psychological causes. Cognitive Behavioral Therapy should be used once the patient is stable on his/her medications–then the patient can use psychotherapy to gain the tools they need to stay on medications and to learn coping mechanisms to handle his/her psychotic symptoms. That is just my opinion. It is extremely difficult, much less impossible, to treat severe Schizophrenia with Psychotherapy alone. I tend to go more towards Michaels side, although, I think both should be used together (psychotherapy more as an adjunct to medications).

    Note from Michael: Like Eri, you are well learned in these subjects. I do agree that CBT will not work without stabilization of the psychosis first. CBT works for Jani now but would not have worked two or three years ago. Psychoanalysis may have value to particular individuals but it depends on the individual.

  8. Sorry to hear that Jani has lost interest in learning. Tearing up books and throwing stuffed animals around. Hope she’ll someday regain her interest in learning again. I think she will. Maybe it’s just a short-term phase.

  9. Re: Psychoanalysis: I can see where one would get that idea. As I said, though, psychoanalysis and psychotherapy — and, in fact, most of psychotherapy — are very much psychiatry’s “thing”, in that psychiatrists created it (which makes sense — it is, after all, a treatment for a medical condition); it is only in recent years that they have turned their back on it. Also, as a note, “psychoanalysis”, at this point in history, is very much an umbrella term for numerous forms of therapy. Many of which have, in fact, been proven to be clinically effective for a wide range of mental illness (ex, Transference-Based Therapy for Borderline Personality Disorder). http://www.psychoanalysis.columbia.edu/research is the link to Columbia Psychoanalytic Institute, who are considered to be the top researchers in this area, if you are curious. You are correct in saying, however, that it has experienced a decline and, in particular, Fruedian psychoanalysis (which, of course, can be summarized as: SEX! in that he believed everything wrong with you in some way involved it) is near non-existent.

    Once again: Psychology is the study of the mind. Psychiatry is the branch of medicine specializing in the treatment of mental illness.

    Re: Environment: Your language was harsh and slanted towards genetics; sounding as if it completely minimized the impact on environment (talking about how, for example, life sucks; but it all just came together in your DNA).

    By the way, I know you mentioned once that Susan wanted to spread out Bodhi’s MMR and believes that might have changed things. I just thought I would add that this is how Japan does it and they have no higher or lower rate of Autism.

    Note from Michael: Interesting re: Japan. And, yes, as I said before, I am heavily biased toward genetic factors (I am fully in the “nature” camp). A lot of this is because it is easier for me to accept what Jani has and what Bodhi have if I can believe that there was nothing I could have done about it. This is not about defending my mistakes but because the only way I can deal with their suffering and the suffering of other children is to believe it is a random act of genetics. Otherwise, God is an asshole. Not very articulate, I know, but I hope I made some sense. You can’t get angry with genes because they are just chemicals and amino acid chains. You can get angry at God.

  10. Actually, I may have misread your message to me. Why do you see them coming together due to psychoanalysis’s decline? It would still be incorrect — as I said, except DBT, all treatment for mental illness originated in psychiatry, with clinical psychology being fairly new — however, I am curious.

    Note from Michael: I still defer to your clearly superior knowledge on the subject but I see them as coming back together because psychologists are beginning to embrace the bio-chemical model of psychiatry, keeping it in mind when conducting therapy. It is an awareness that not everything is ultimately in the “control” of the patient.

  11. I know all readers are entitled to their comments but I think Eri and Samantha are missing the point.
    You never claim to be an expert on psychiatry, psychology or the cause of autism. You are just a Dad sharing your ideas on the subject from someone whose children suffer from these areas. Theres no reason to correct you on your opinions.

    I always appreciate your raw, honest view of life from someone in a very unique position. Your writing is articulate, heartwarming and at times painful. But we cant hide from the pain when its the truth. Anyone who can criticize you has never walked in your shoes. I try to be a great parent but I lose patience all the time and my kids are healthy. I cannot imagine having to entertain imaginary friends on a regular basis.

    I wish more parents would have the courage to share their stories of real life in difficult circumstances. None of us are perfect although many try to give that impression. I am always grateful that you allow us a small glimpse into your world without sugar coating it.

    I am among many everyday parents who saw Jani’s story and can never forget her. She is an amazing girl and I will be following and supporting your journey for as long as you allow us into your world.

    Thanks again and I’m looking forward to the book!

    Note from Michael: Thanks, Carol. You are correct. I don’t claim to be an expert but I learned long ago that people take from this blog what they want to take and, frankly, that’s okay. Different people take different things away from what I write and that’s fine. I learn. They learn. Nothing wrong with that.

  12. Your honesty
    I really appreciate how you are not afraid to say what you think, probably because usually I agree with you. I think you are dead-on in your analysis of vaccine avoiders. And I also think those of us with children with genetic disabilities probably give more respect and credit to genetics versus environment, because all the nurturing in the world isn’t going to take away our kids’ problems.

  13. Re: one of the comments michael made
    When it comes to Jani’s condition genetics is most likely to blame almost solely. While twin studies have shown that there is both a genetic and environmental factor to schizophrenia these studies focus mainly on adults who did not develop schizophrenia until early adulthood or later. Since Jani’s condition developed so early in life it is likely she has a genetic abnormality and that there was nothing you could do.

  14. Music lives somewhere deep inside our heads. Almost everything I think or remember has a soundtrack. My mind likes to play word association games with everything and line up a song for it. Sometimes, it annoys people who know me…

    Anyhow, this entry, with the genetics discussion, put this song in my head; [url]http://www.whokilledamandapalmer.com/song.php?track=2[/url]
    and I thought I’d share it. It is a bit too lyrically frank for a child, but you might like it on your own.

  15. The interesting thing about Psychologists today is that the majority of their research — both clinical and non-clinical (most of it — studying healthy behavior, development, etc) — tends to be cognitive and neuroscientific (am unsure if this is a word) in leaning. They heavily use fRMI and PET scan techniques in their lab to study just about everything (as an example, many of them have been involved in studies detailing the brain development that occurs in adolescence). Psychiatry uses similar technology, of course, just only on abnormal thought, behavior, development, etc.

    Re: Genetic leanings: Ultimately, as long as one’s coping technique is not harmful (drinking, smashing walls, something that causes a disconnect from reality, etc), one needs to do what they need to to preserve their own sanity and emotional health [as best as is possible]. As an Atheist/Secular Humanist — something I became not because of negative life events; but because of my own explorations — there is no God for me to be angry at. The Universe just is. As I tend to tell people, finally realizing that I found the idea of God to be absurd* and coming to terms with that has done more for my mental health than anything else.

    As for my own theories, though I do tend to lean more towards environmental, I consider myself as having a balanced approach between genetic, non-life experience environmental factors (ex, hormone released during pregnancy. I do believe far too many forget that environment in science = anything other than DNA. Including, you know, the weather) and life-experience environmental factors. I believe that no person is going to have the same combination — including two people diagnosed with the same thing, as the words “Schizophrenia”, “Bipolar”, etc are most likely actually many different disorders that simply present similarly. With treatment, I believe it should be approached with a Social Psychiatry model, a model of treatment that focuses on functioning within a community just as much, if not more than, just symptoms. In other words, the goal of treatment should not be to get rid of symptom of X, Y, Z, etc, it should be to raise someone’s level of functioning as high as possible; it just so happens that symptom reduction is a large part of meeting that goal (does that make sense?).

    If you don’t mind me asking, by the way, has anybody ever tried to teach Jani techniques to keep herself stimulated? A skill-building approach, in other words. It may have to wait until she gets a tad older; however, I believe the ability to do that — and I do believe it is something that, with the right supports, she is capable of — will be a gift to her functioning and happiness.

    Autism: Epidemiological studies show us there is no long (ex, what happens when you follow a kid who got the MMR and one who didn’t? No difference in rate in Autism). It is, however, likely a disorder with a strong environmental component (a somewhat recent study showed this); however, those factors influence development in utero (is anything from taking an SSRI, stress on the mother, being pregnant during certain times of the year, etc) and, as such, it is already set in motion by the time the child meets the world for the fist time.

    *I have nothing against the religious or being religious. One can believe as they wish as long as they are not harming anyone. But, I am an Atheist as I find it logical to be (and I would argue most are — as an example, most don’t believe in the Greek Gods. I am just an Atheist towards one more than most) and feel no inclination to believe without solid evidence (“the proof lies with the claimant”).

    Note from Michael: Totally agree on many of your points. I have never felt that the diagnosis matters as much as level of functioning (and when I say “functioning,” I don’t mean “conformity to social norms.” I mean, quite simply, being happy with one’s self and able to live with dignity. “Schizophrenia” is largely a meaningless term, except for its power to shock the public from complacency regarding treatment for the mentally ill. It is, as you say, likely a spectrum. It is true that no two individuals with schizophrenia will present exactly the same way (or any other mental illness), which is part of what makes diagnosis so tricky. My goal is ultimately the same as yours: we both want sufficient support and resources that allow those with mental illness to live full and fulfilling lives IN THE COMMUNITY and to be accepted as part of that community. Medications and therapies are not designed to “treat” but to improve functioning and anything that does that is a good thing.

    The reason I push biology so hard is because I want to push society away from the idea that mental illness is nothing more than “behavior” than can be “fixed.” Such ideas blame the victim for his/her behavior, rather than biology. I suppose it a defense mechanism that sprang from the time when Jani was mean to other kids for no apparent reason: I desperately needed to believe and wanted others to know that her behaviors were not a character flaw but a biology she couldn’t control. Since then I have seen so many mentally ill kids get labeled as “bad kids” (sometimes even by their parents) and it breaks my heart because I know they can’t control their thoughts/emotions. That is why I push biology so hard. It is to take away the stress for these children of trying to conform to a set of rules their biology will not allow for.

    As for psychologists, I have not found many I respect. In my experience and the experience of many I know, the psychologists have “quit” or bailed out because they didn’t feel they could help the child, thereby further destabilizing the child. Most have no experience with psychosis and don’t have the fortitude to stick it out. I am still waiting for a psychologist to change my views on them.

  16. Carol: ? I didn’t think he was claiming to be an expert, nor was I attacking him. I have known (well, known via net, phone, etc) and have considered the Schofields friends (lol, I assume it’s mutual?) for quite some time now. My posts are simply those of friendly, intellectual exchange.

    Note from Michael: It is mutual. I find your posts quite interesting, even if we don’t always agree.

  17. Oh, looking back on my posts I realized that, without context, it looks as if I am jumping down your throat. To everyone who reads: I’m not! Truly, just friendly exchange.

    Note from Michael: Yes, it is. Eri and I have known each other awhile.

  18. Hi Michael,

    I love this blog. The music is some of the best part. Music goes where words can’t. How do you pronounce your son’s name? I’ve always heard it in my mind as BOD (as in body) -HE.

    Note from Michael: That is how you pronounce his name.

  19. Michael, you’ve probably heard of Elyn Saks, a brilliant woman with many degrees and a MacArthur Fellowship…and schizophrenia. She’s very high-functioning, of course. Anyway, relating to psychoanalysis: in Elyn’s memoir she said psychoanalysis was her only treatment for her schizophrenia for decades, and while seeing an analyst a few times a week she was able to live. It wasn’t until middle age that she started taking anti-psychotic meds as well.

    I’m not, of course, suggesting that you should do this with Jani — God forbid — or that this would work for more than a small minority of people with schizophrenia. But since we’re talking her about psychiatry and psychology and psychotherapy, I thought I’d throw it in to the discussion.

    Note from Michael: Know of her? We’ve been lucky enough to meet her a couple of times. She was supposed to be part of the Discovery Health special. The filmmakers shot a day between Jani and Elyn but it wasn’t used in the final documentary unfortunately. Great, great human being. And, yes, I have read her book. In her case I think it worked, and I think even she would admit, she had a rare psychoanalyst in terms of her total commitment and her not batting an eye at the psychotic things Elyn would say. Unfortunately, most therapists just don’t have this kind of fortitude.

  20. Michael, I agree with your statement, she is a great person–even though I have not met her. I read her incredible book called “The Center Cannot Hold”, and it was such a sad and yet hopeful book that shows that recovery is possible for even the most severe. I am so glad that you guys have met her, we need more professionals like her. I was wondering if you guys have met Joe Pantiolano? He has been an advocate for people with mental illness, and he happens to be an actor.

    Note from Michael: Nope, Ruben. Haven’t met Joey Pants. Elyn was a special situation because she was able to meet Jani and they went for a walk on the USC campus. Actors tend to be at social events/fundraisers, which we can’t make it to (like the Flawless Foundation fundraiser last month) because they happen at night and that would be too disruptive to the kids.

  21. Music
    I think you’re wrong about the music. Or maybe the person who made the original comment was wrong and you just kind of accepted his “diagnosis” that it’s high-school. No it’s not. Music is so huge it’s indescribable. Music is a healer. Music can relate to us – or us to it – or relate us to ourselves, maybe. One of my favorite quotes about music is by Sarah Dessen: “Music is a total constant. That’s why we have such a strong visceral connection to it, you know? Because a song can take you back instantly to a moment, or a place, or even a person. No matter what else has changed in your or the world, that one song says the same, just like that moment.” Don’t let anyone tell you what music is or isn’t. Music is personal like nothing else will ever be. It’s not high school. It’s human.

  22. “Critics who treat ‘adult’ as a term of approval, instead of as a merely descriptive term, cannot be adult themselves. To be concerned about being grown up, to admire the grown up because it is grown up, to blush at the suspicion of being childish; these things are the marks of childhood and adolescence. And in childhood and adolescence they are, in moderation, healthy symptoms. Young things ought to want to grow. But to carry on into middle life or even into early manhood this concern about being adult is a mark of really arrested development. When I was ten, I read fairy tales in secret and would have been ashamed if I had been found doing so. Now that I am fifty I read them openly. When I became a man I put away childish things, including the fear of childishness and the desire to be very grown up.”
    ― C.S. Lewis

  23. It’s not “high school” at all. I have actually wondered how many people are like me: to hear a song and have a flashback to a very certain scene..the smell, the people.. all of it. But you are right. I tend not to listen to the songs at the end of your posts. Why? I am reeling. Isn’t all good writing like that?

  24. ….
    1. I love your writing style. I love your honestly. I love your hostility at times. And I love how you are so open to listening to what others have to say about what you write.

    I mainly wanted to ask you if you’ve ever tried having Jani write in a journal when you need a break from her? Or if you think that maybe she would like doing that on her own anyways. Because there she could talk about her imaginary friends all she wanted – unless you don’t want her to continue such a strong relationship with them – and you could tell her that you will read about what she write later.

    Just trying to be helpful!

    Note from Michael: No, I think it is a great idea when she gets older. Right now, getting her to write is difficult. She doesn’t like to do it because when she makes a mistake she gets frustrated. We are helping her work through that so I hope one day, yes, she will keep a journal.

  25. Music
    Do forgive me if the topic has been covered already, but how about music lessons specifically a string instrument. Having many symptoms as your daughter, becoming quite overwhelmed with the smallest life task, I’ve found that playing the violin is soothing. Feeling the vibration of the strings against my face, not only calms but quiets the busyness of my brain. When having a particularly overly bad day, I play in the dark with only the light of my computer viewing the music as a PDF file on my monitor. It seems dimly lit rooms cuts out stimuli that my brain fails to filter and playing relaxes me to the point that I sleep deeply. When I started I could not play one note counting to 4, without becoming distracted, frustrated usually both, but now I can play a sheet of music without stopping. In addition to the relaxing feeling of the vibrations, my brain actually is happy having so many things to work-on to complete the sound. What is really cool is that the activity of playing felt good even before I could read notes and produce clear tones. One interesting note, when taking lessons I did much better watching the teacher play. I mimic well and since easily distracted, understanding through oral instruction was most difficult, frustrating and next to impossible. Also found it unbearable to listen to instruction while playing, but working with the instructor that was willing to teach to my needs brought about an easy remedy. Last, I replaced my regular string with octave violin strings, (they tune an octave lower on all strings sounding closer to a cello, and produce an extreme number of vibrations). Tried playing the piano first, but found it was the vibration of the strings that calmed the overwhelming raging in my body. Really appreciation the dedication of you and your wife and pray the best for your family future.

    Note from Michael: That is really great, Shelley. I am very happy with you. Susan and I are considering it. We just need to find the right instrument and, as you pointed out, the right teacher who has the patience. Interestingly enough, Jani has written songs with “Mrs Music” the music therapist at UCLA when she is inpatient.

  26. I love the videos
    There are a million things I want to say about how much you and Susan comfort me, how much Jani inspires me, and how having a mental illness HAS held me back BUT as I accepted it and got over the stigma and shame of it I became a WAAAY better person that I would have been without the illness… go figure.

    I was diagnosed withe bipolar disorder about a year ago but I MIGHT also have other probles that are similar or related to bipolar disorder OR that might be caused by severe mood swings

    I have accepted that being bipolar is my truth and reality. It is no one’s fault, it is probably genetic odds.

    Anyways, I have bipolar disorder [diagnsed] or something similar but I have still done well in life, have great friends, and even a serious romantic relationship where he KNOWS I have mental illness hurdles and not only loves me anyways, but goes to great lengths to support my efforts to maintain and improve my baseline. I am extremely lucky!

    Jani inspires me that I can be strong. You and Susan comfort me becuase when I see others love and care for someone with a mental illness, it reminds me that people will and do love me too and that my illness struggles did not run them off.

    Thank you for being amazing. You are the greatest parents ever and are heroes to SO MANY people out there – especially those with a mental illness and those who care for persons with a mental illness.

    I see how you both are and it makes me re-think my support-system and the challenges they take on to help me.

    Thank you and I will always keep your family in my thoughts and prayers!

    [Hope this wasn’t too off-topic or disorganized!]

    Note from Michael: No, you were very focused. Thank you. You inspire me as well and help to give me hope for Jani. Thank you for that.

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