“A Fight To Be” Ronald Bassman
September 11, 2008
“A Fight To Be,” Ronald Bassman, Ph.D.
Reviewed by Paul Pines*
Ronald Bassman’s book, A Fight To Be, is a daring and insightful portrait of psychosis and the “mental health” system we have put in place to address”chronic and persistent disorders”. The book is a weave of three distinct threads: it is a personal memoir, a clinical meditation and, finally, rising from that dialogue, a call to action. The first thread offers the authority of the author’s direct experience as one who was diagnosed with and treated for paranoid schizophrenia; the second gives us the perspective of an informed, acutely observant clinician; the third, an opportunity to exercise our social conscience–or, perhaps, in the spirit of Dietrich Bonheoffer, to create one
The memoir is a classic Hero’s Journey in which the hero undergoes a series of challenges involving descent into the underworld, pitiless adversaries and death and resurrection in order to realize an authentic self and heal the Wasteland, a culture without compassion. As Parzival, the 12th Century Grail knight learns, “We are what we make of our pain.” It is the lesson of one transformed through struggle from warrior to healer, but where Parzival’s journey begins in Edenic innocence, Bassman’s starts at the extreme of psychological fragmentation.
In 1966, at the age of 23, following the completion of a Masters program in clinical psychology, Bassman makes a conscious decision to let go of an image of himself attached to his academic achievement which he can no longer support. What he has taken for granted as his inevitable identity has the heavy hollowness of a suit of armor. He describes taking it off in a way that allows the reader to experience the consequences of doing so without agenda, and herein lies the power of his tale.
Bassman’s response to stripping away this weight is an altered consciousness, a “lightness of being” that includes paranormal powers. Playing four-card monte at a gambling table in Union City, New Jersey, he anticipates the cards well enough to walk out a winner, an event the author looks back on and wonders “if the many phenomena…I remembered did in fact happen.” Shortly thereafter, at the urging of his parents, he winds up in the psychiatric ward at Fair Oaks Hospital, in New Jersey, where, as he tells us, “I entered the abyss.” He is there stripped of his dignity, and given the message that he is doomed to a life of mind-numbing drugs, and is subjected to a regimen of the now discredited and potentially life-threatening insulin coma therapy. Bassman receives forty-nine insulin treatments and is released seven months later. Six months after that, through an act of will, he has weaned himself off all medications. His success at remaining medication and symptom free ever since, while performing as an academic, clinician and author, has shaped his position as an activist/advocate for a drug free approach to the treatment of psychosis and other mental health issues.
In a seamless way, the author draws on his clinical as well as his personal experience of psychoses to discuss what he has learned. For this he references on the pioneering work of Jung and R.D. Laing, who assert that there is logic to delusional content which can be decoded. While Laing, and to some extent Jung, are viewed lass favorably now than they were in the 60s and 70s, the basic humanity of their “depth” approach to the inherently healing impulse of the psyche, in connection to the humanity of the healer, have been displaced by a culture of measurement, and a distancing professionalism. This has been fortified by the advent of designer drugs which offer hope with one hand and take it away with the other by enabling the management of psychotic symptoms to serve as an end in itself. To accept this, Bassman asserts, is to abandon the hope of integration, a journey which challenges us to heal the Wasteland and renew our capacity to relate with compassion, to validate the fight to be. He renews the call for a psychotherapy that, in Laing’s words, “must remain an obstinate attempt of two people to recover the wholeness of being human through the relationship between them.”
A strong advocate of self-help and consumer empowerment, Bassman takes on a number of controversial issues. Should we force medication on those who refuse it? Can we commit an individual to an institution against his will who has done nothing but raise the suspicion that he may be a danger to himself or another? Should we put the mentally ill in penal institutions? How do we help those who have fallen into the abyss? As an activist, Bassman’s voice deserves to be heard. Even where there is no definitive answer, the point of view is that of knight-turned-healer. He suggests that the measure of a civilized society is its ability to locate the potential for wholeness in those who suffer most. Bassman asks:
But what of the person who is called mad? Is there no psychotherapy that will work with her? I believe such work is possible, but therapists must firmly relinquish their reliance on diagnosis and their illusions of precise predictability. Each person lives a personal and special life story.
A Fight To Be, is a crie du Coeur, as well as a penetrating psycho/social analysis of where we find ourselves in relation to those who are among the most disenfranchised. It is also the last task of the Hero, who must not only return from the depths, but to tell the story of his journey so that we may be renewed. The challenge to retain hope on the way to self empowerment is daunting. Though people diagnosed as mentally ill are no longer chained to the walls of institutions, there are still the invisible shackles of stigma and poverty reinforced by a system that accepts hopelessness as the status quo. Bassman, the clinician, describes a typical Day Treatment group:
The glazed eyes, the missing teeth, the trembling hands, distended stomachs, slurred speech and other drug-related side effects will not be remarkable there. I look and see squelched dreams and resignation. I wonder what their lives were like and what could have been?
The Wasteland this book describes is a system/culture that has become so compartmentalized that it can no longer address those it serves. Psychiatrists dispense drugs. Social workers and psychologists treat individuals in sessions of limited frequency and duration with therapies that lack continuity and depth. Even under the best of circumstances, treatments are directed at symptoms rather than underlying causes. What we are talking about is a degree of unconsciousness in the system as profound as in those who seek refuge in it. “Staying out of the hospital is essential to the development of self-confidence,” writes Bassman. “It is almost impossible not to measure your success by the increased time you are able to take care of yourself.”
Here, says the author, is the evidence. He argues that this condition can be changed. His authority is earned. Bassman speaks as one who has suffered the fierce storms of psychosis and overcome the message that life holds no more for the consumer than the narrow protocols of drugs and containment. His is the voice of one who has defied therapeutic stagnation and by an act of will moved beyond the received wisdom of “normalcy” to find the authentic voice that informs these pages with the promise of hope.
I believe that as long as a person is alive, some seed of hope, some possibility is there waiting to be fertilized. Hope fights the fear, nurtures the courage and inspires the vision and the work required to resist giving up…Deep in the recesses of our being there are safe sanctuaries, secure hiding places for never fully lost dreams. But sometime they are hidden so well that we can no longer reach those parts of ourselves.
*Paul Pines is the author of the novel The Tin Angel (Wm. Morrow) and a memoir My Brother’s Madness (Curbstone Press). He has published six books of poetry, selections from which have been set by composer Daniel Asia, and recently finished an opera libretto based on The Tin Angel. Pines is a psychotherapist in private practice in Glens Falls, NY.
If you are interested in purchasing A Fight To Be, please visit Ron’s Website.
This article was originally published on MIWatch: http://www.miwatch.org/
Ann Wroth
September 11, 2008
YESTERDAY I HAD THE KEY . . .
One day I was working as a social worker in a psychiatric hospital. The next day I was signing myself into a locked unit at another area psychiatric hospital.
The one thing I had never realized while working in the hospital (including doing admissions work) was the sheer terror and sense of loss of control that a psychiatric hospital admission causes. What an identity shift is required. A letting-go of identity and taking on an unfamiliar one.
I was at work when my doctor and I decided I should admit myself. I went home to pull some things together, but I didn’t change out of my work clothes. I think I wanted to hold on to some shred of my identity as a functioning person (even though I wasn’t really functioning very well at that point). I must have looked so odd to my soon-to-be fellow patients as I toured the unit in my dress and pumps. And it was a locked unit!
At the hospital where I worked, adult patients were in an open unit and I breezily asked (masking my fear) the admissions person as we went to the unit if it was a locked or open unit – my heart sank when she told me it was the former.
So, there I was at the hospital. Alone. It was a long and lonely first night. But I didn’t know then that in addition to working on my own problems with depression and anxiety I would be learning some valuable life lessons as well.
Lesson 1: The first morning I was at the hospital I joined the other patients for a unit meeting. Who should I see but two former clients from my first social work field placement in a day program for people with serious and persistent mental illness. They didn’t recognize me at first, but there was an immediate “a ha!” moment as I felt the great equalizer of psychiatric illness. Eventually they both recognized me, each asking me “Wait, aren’t you a social worker? What are you doing here?” And I could only reply “Yes I
am, but I am having problems too.” We were all thrown off-kilter by the role-shift.
Lesson 2: While being herded to the dining room one day, I saw across the room a woman I had gone to social work school with. She was obviously working at the hospital. I saw her a few times and we never spoke. Finally I went up to her and said hello, asking how she was doing and suggesting that she was probably doing a little better than I was, given our current roles. I was determined to speak to her and not give in to the stigma of being ill. It felt good to take the first step by approaching her.
While that first inpatient stay was valuable in many ways, I came to feel safe in the patient role – passive and protected from myself – and it was difficult to regain the lost time. But that’s another whole topic. This stay did bring into sharp focus the fact that there are no major walls between the well and the ill. Defensive barriers notwithstanding, we are all on a great continuum in our level of functioning, our level of pain, our ability to deal with the challenges of life, with or without a mental illness.
My lessons continued after I was discharged and finally ready (I thought!) to go back to work. At one interview, touring the inpatient psychiatric unit of a local hospital, I ran into my room-mate from my hospitalization, disheveled, being led out of a “quiet room”. She said hello and I felt that I should respond – to do otherwise would be belittling to her and not honest. At virtually the same time I saw another former classmate of mine, who wondered how I knew the woman. I fumbled a bit and then said that I knew her from another program. Not graceful, but it was the best I could do in the midst of a job interview!
So, it’s illusory, any division we place between ourselves and our patients or clients. In any group of social work, psychology, or psychiatry professionals (or students), one need only look around the room to see the walking wounded. Chances are that one or more of your colleagues at any given time is feeling as desperate as I was that day that I went into the hospital. We must not prevent people (ourselves) from getting help because of some defensive construct that divides “us” professionals from “them” patients/clients.
Yesterday I had the key. Today I neither need the key nor to be within the confines of a psychiatric unit. I am working at NAMI, the National Alliance on Mental Illness. I work on a toll-free helpline, talking to family members of people with mental illness and to those with mental illness as well. I was 10 years away from clinical social work. Now I provide direct service of another kind. And I’m happy.
Tomorrow is an open book – and I hold the pen.
Greg Kim
May 17, 2008
Recovery is tough. I came into the mental health system in extreme emotional distress. I was suspicious of people and overwhelmed with sadness and hopelessness. I didn’t really see much of a future for myself and had a hard time even making it through the day. Life was a struggle. For me, getting a diagnosis of schizoaffective disorder, taking medications that made me feel in a fog and being locked up against my will were frightening and not hope inspiring.
It took years before I really thought that I would get better. I was stuck in a cycle of pain and running to the hospital for help. But it wasn’t really the type of help that I needed. Once I got to hospital, I wanted out. But there were people who helped me out of the mire.
They were like the exceptional jewels in the system. These were the people who believed in me. They never judged me and always held me in high regard even when I was doing some really reckless and potentially catastrophic things.
The journey to recovery took time, work and deep soul searching. My journey led me to learn about other ways to stay safe in tough times. It led to me discovering other ways to interpret what was happening around me. It guided me to discover the things that I needed to do on a daily basis to stay well. I still do these things daily. When I don’t do them I can see the storm clouds of despair forming on the horizon.
Recovery for me isn’t living without these feelings of suspiciousness or sadness but learning how to incorporate them into my way of being. It’s about learning how to make them a part of me to navigate the world. They are a gift, a crazy mad gift. But it allows me to be more sensitive and empathetic to people and my surroundings. It allows me to care about my work and school and gives me passion. These feelings aren’t present as often and as for long as before. Now they act like my early warning system when my life is getting out of control.
You never know where you are going to end up in life. Once I decided that the pain of changing was less than the pain of what was happening, I started a new path from illness to wellness and hope. I’m still on that path. I stumble but I have hope and can see a better future.
“Greg Kim is the chair of the Consumer/Survivor Information Resource Centre of Toronto and treasurer of the Ontario Council of Alternative Businesses. During the day he is the Consumer Participation Initiative Coordinator at the Canadian Mental Health Association - Toronto Branch. Greg also loves his cat Minoune.”
