Listening for the Person within “Madness”

As we struggle to invent a humane approach to the extreme states that get called “psychosis” or “madness” or “schizophrenia,” it may be helpful to investigate some of the better approaches developed in the past.

While these approaches are not without their flaws, they are often surprisingly insightful.  (It can also of course be depressing to notice how truths once more widely known were so easily “forgotten” as compassionate approaches got ditched in favor of the latest coercive innovations.)

One of the pioneers in actually listening to those in extreme states was Frieda Fromm-Reichmann.  She advocated assuming that every communication from those in extreme states contains meaning, and for appreciating that there is an “ego,” however beleaguered, within even the seemingly “hopelessly deranged.”  She believed that if therapists would persist in reaching out, while respecting the person and his or her struggle, then communication would gradually become clearer, and the person’s special perspectives and talents could emerge and flourish.

Fromm-Reichmann is perhaps best known as being the therapist for Joanne Greenberg, who wrote a fictionalized version of her story of psychosis and recovery in the novel “I Never Promised You a Rose Garden,” and whose story was also covered in Daniel Mackler’s documentary “Take These Broken Wings.”

One person who has extensively studied the work of Fromm-Reichmann and others like her is Ann-Louise Silver, MD.  In the short clip below, taken from the “Broken Wings” documentary, she contrasts the kind of recovery that can come from psychodynamic therapy with what happens when people are offered what she calls the “scotch tape” approach of medication:

So how does this psychodynamic approach work, and what parts of Fromm-Reichmann’s approach could be helpful to us as we design alternatives for today’s world?

Ann will address that topic at an ISPS online meeting on Friday 2/13/15, at 3 PM EST.  This meeting is free to ISPS members, with a donation of $5-$20 requested from others, though there is also an option to register without donating if that works better for you.

You can register at

Ann will also be a keynote speaker at the ISPS International Conference in NYC March 18-22, 2015.

Ann was the first president of ISPS-US, an organization started by people who were mostly psychodynamic therapists.  This organization has since broadened, as awareness increased about the need to collaborate with those who have lived experience, and as knowledge expanded about the effectiveness of other kinds of approaches, and of the need to have different approaches available for people who may respond better to something other than long term therapy.

It certainly isn’t too late to register for where you can hear from leaders such as Mary Olson (of Open Dialogue), Aaron Beck and Tony Morrison (of CBT and CBT for psychosis), and of special importance, lots of people with both lived experience of psychosis and expertise in other areas, such as Ron Coleman, Pat Deegan, Noel Hunter,  Sascha DuBrul, and Oryx Cohen among many others.

I will also have a presentation there, titled “Admitting Uncertainty about “Illness” and “Reality” is Essential for Dialogue.”

Of course, many of you aren’t going to be able to attend big conferences like this – which is why I hope to keep working with others in ISPS to make available online meetings, accessible to all, which give people a chance to hear from leaders in our field in a live format that includes interaction with the audience.  Expect to hear more about these meetings on MIA, and/or you can always hear about what’s coming up by going to

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Finding the Gifts Within “Madness”

When people are seeing the world really different than we do, it’s often reassuring to think that there must be something wrong with them – because if they are completely wrong, or ill, then we don’t have to rethink our own sense of reality, we can instead be confident about that own understandings encompass all that we need to know.

But it can be disorienting and damaging to others to have their experiences defined as “completely wrong” or “ill.”  And we ourselves become more ignorant when we are too sure that there is no value in other ways of looking or experiencing.

In a practical sense, there are often many ways for example to look at a particular object – we can look at it from various angles, and through different lenses for example, and what we see will be different depending on how we look.  In that sense, it’s actually ridiculous to see one way or another of looking or experiencing as “wrong” or “sick”; instead, it makes more sense to understand that different ways of looking may be useful for different purposes.

Looking at things the same way as others around us are looking at them can certainly be helpful if we want to understand what others are seeing and to coordinate with them.  Looking at things in more unique ways may be more helpful though if we have other purposes:  for example looking at part of a tree through a microscope may be very helpful for some purposes, even though it is unhelpful for seeing the tree in a conventional way.

In a fascinating recording titled OF MADNESS AND MAGIC: SHIFTING THE LENS TO UNDERSTAND THE MIND, Mischa Shoni shares both her own journey and also some great insights into how discovering new ways of looking at the world, or new “lenses” to look at it through, can be both disorienting and disabling, and then eventually enriching once one learns how to use those lenses in a good way.

Here’s the written description of her talk:

What differentiates what is labeled as mental dysfunction—mania, psychosis, seizures—from what is magic, spirit, or simply … beyond the scientific method? Mischa Shoni embarks on a journey to understand her own brain. On the path, she meets dragons, gryphons, crystal-eyed snakes … and some extraordinary people who see the mind beyond the limited lens of psychiatry.

Continue reading

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Online Meeting Focuses on “Responding to Extreme States with Loving Receptivity”

Northern California has played an important role in the development of “alternative” approaches for psychosis, especially with the establishment of madness sanctuaries like Soteria where people could undergo psychosis with very little use of drugs.

Our next ISPS online meeting will provide a chance to meet with modern day pioneers from Northern California, who along with others in the Bay Area Mandala Project, plan a number of alternatives, including a Soteria-like residence.

Cardum Harmon, Dina Tyler, Michael Cornwall, PhD are key members of the Mandala Project, and they will be the presenters for this meeting, which will address “Responding to Extreme States with Loving Receptivity: Honoring the Spirit’s Transformative Journey”  All three have lived experience of “psychosis” or “extreme states” as well as extensive experience helping others with those states.  (Michael also has had experience working in I Ward, one of those alternative facilities that helped people with psychotic experiences without using antipsychotics.)

In this meeting, they will share effective ways to be with people in intense spiritual experience by focusing on loving receptivity and the importance of honoring one’s spiritual journey. They will explore the strategy of “being with” instead of “doing to”, as an accessible tool for averting prolonged crisis and supporting healing. Continue reading

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Tony Morrison, another reason to register for #ISPS2015NYC !


  Plenary Highlight: Professor Tony Morrison

We are pleased to welcome Tony Morrison as a plenary speaker at the 19th conference of ISPS, to be held in March in New York City.

Dr. Morrison has been a leader in developing the application of cognitive behavioral therapy to the problems of psychosis (CBTp). His research has focused on delineating the elements of CBTp, examining links between trauma and psychosis, and exploring patient choice and user-led research, as well as research on the effectiveness of CBTp for people not on antipsychotic medication. He has written many articles, as well as treatment manuals, and is a professor at The University of Manchester, UK.

A link to a YouTube video of a keynote presentation at the British Psychological Society on “Cognitive behaviour therapy without antipsychotics: Is it effective across the continuum of psychotic disorders?”

For a selected biography:

A more extensive biography:

Read more about Tony Morrison

Note that Tony is also presenting a pre-conference workshop – one of a number of them!  And December 15, 2014 is the last day to get the Early Bird Discount when registering…..

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Understanding Psychosis and Schizophrenia – A Valuable, and Free, Online Report

What would happen if a team of highly qualified psychologists joined up with a team of people who knew psychosis from the inside, from their own journey into madness and then recovery – and if they collaborated in writing a guide to understanding the difficult states that get names like “psychosis” and schizophrenia”?

Well, you don’t have to wonder anymore, because the result was just published a couple of days ago in the form of a report that is free to download at Understanding Psychosis and Schizophrenia

A fundamental point made by the report is that “‘psychotic’ experiences are understandable in the same ways as ‘normal’ experiences, and can be approached in the same way.”

I believe this report will be useful to a great many people, because of the way it combines a thorough knowledge of the science with common sense and perspectives drawn from actually listening to people who have had these experiences and then have made sense of them for themselves.  The knowledge in this report will likely both change the perspective of many professionals, as well as be of assistance to many individuals and families who want a deep understanding of the subject that is also  very accessible and easy to read.

It includes  a list of resources at the end which many people may also find helpful.

Jacqui Dillon, Chair of the UK Hearing Voices Network, was quoted as saying:

This report is an example of the amazing things that are possible when professionals and people with personal experience work together. Both the report’s content and the collaborative process by which it has been written are wonderful examples of the importance and power of moving beyond ‘them and us’ thinking in mental health.

I fully agree.

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One Perspective on the Upcoming International Dialogue, ISPS in NYC 2015

As awareness spreads about there being something wrong with existing approaches to “psychosis” aka “madness,” interest grows in exploring what to do instead.

One interesting meeting place for exploring “what to do” will be the ISPS conference in NYC in March 2015, which is titled “An International Dialogue on Relationship and Experience in Psychosis.”

This conference promises to stand out in terms of the variety of voices,  perspectives, approaches and traditions that it will bring together to focus on the deeper issue of how helpers can best understand and interact with those experiencing what is called psychosis.

I’ve been a member of ISPS (The International Society for Psychological and Social Approaches for Psychosis) for many years now; I currently serve as chair of the education committee for the US branch of ISPS and I’m the lead moderator for its US list serve.  What keeps me interested in this group and its discussions is the focus on understanding psychosis in depth, the willingness to look at it from a lot of angles, and the interest in service models that address the true complexity of the issues people face while maintaining hope for understanding and integration, not just the suppression of unwanted experiences.

In some important ways, the subject of how to make sense of psychosis cannot be separated from the subject of how we make sense of our own existence at its deepest levels.  Often it seems there are a wide variety of possible ways to make sense of things, but then there is the challenge of how to make sense of all these possible explanations and perspectives, and how to talk to each other so that we can share our experience and work together in various ways.  This problem can exist at various levels:  within and between the “parts” of an individual mind, between an individual in crisis and someone trying to help that individual, and between and amongst all those who together form a mental health system or even a culture, etc.

The best approach to these potentially bewildering and overwhelming issues seems to be dialogue, a dialogue which doesn’t determine any final answers, but does improve relationships at various levels, and encourages multiple approaches to understanding.

I value the dialogues I have found within ISPS:  these dialogues have allowed me to improve my understanding of madness and to increase my ability to communicate what I understand to diverse individuals and audiences.  I think if we are ever going to shift society and the mental health system into a wiser approach to extreme experiences, we all need to find such opportunities for dialogue so we can hone our ability to connect with people coming from a variety of different backgrounds and levels of understanding.

The international conference in NYC aims to compress a lot of such dialogues into just a few days!  This conference will bring together not just people from all over the world but also people holding a wide variety of perspectives:  psychiatrists, other mental health professionals, people with lived experience,  family members; and people from schools of thought as varied as psychodynamic, CBT, Open Dialogue, Art Therapy, the Hearing Voices Movement, and biomedical perspectives.

Continue reading

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An ISPS “Online Meeting” with Bertram Karon

ISPS is beginning to hold online meetings, which are expected to occur about monthly.  The first such meeting will be Friday 12/12/14, noon EST, featuring Bertram Karon on the topic of “Who am I to treat this person? What it feels like to treat a ‘seriously mentally ill’ person.”  Those who attend will have opportunities to ask questions and to share their thoughts.

For those of you not already familiar with Bertram Karon, you should know that he has extensive experience providing therapy for people diagnosed with schizophrenia and in researching such therapy, and is co-author of the book “Psychotherapy of schizophrenia: The treatment of choice.”   He was also recently interviewed on Madness Radio.  You can read a bit more about him, and also register for the online meeting, at .

(Note that a donation is requested from non-members of ISPS, though no one is turned away for lack of funds.)

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Get a Great Deal on ISPS Books Until 12/31/14!

ISPS publishes a number of books listed here – anyone can use the access code “ISPS14” to get a 20% discount when buying ISPS books from Routledge (use that link) before December 31st, 2014.

The most popular book in this series has been “Models of Madness:  Psychological, Social and Biological Approaches to Psychosis” edited by John Read (who has extensively documented the links between childhood adversity and psychosis) and Jacqui Dillon, chair of the UK Hearing Voices Network and an international speaker and trainer.  This book is now in its second edition.

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ISPS New York 2015 – Submission Deadline for Presentations Extended to October 20th

Due to popular demand and academic schedules, ISPS is extending the deadline for submissions/proposals to present at the NYC International Conference to Monday, October 20th.

If you have already submitted a proposal, please do not submit it again. We have a sizable number of submissions and would like to avoid duplicates. We look forward to your submission.

The ISPS conference is probably the world’s best gathering for those broadly interested in psychological and social approaches to psychosis – don’t miss out on NYC 2015! We welcome members of all disciplines, experts by experience and family members. Please take a look at the preliminary programme and visit the conference website for further information

Ideas for papers, posters, symposia and workshops should be submitted by

Monday October 20th

Submission guidelines

Submission form

The early bird registration rate continues until December 15th.

Register here

A warm welcome to ISPS in New York!


For further information about ISPS visit

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Getting to Know the People Making a Difference: Lisa Dixon is One!

How to best help people with psychosis is a controversial subject, so what some people see as “progress” other people might see as a bad idea.

But we need to talk about it, to understand what different people are thinking, and why.  That’s why the international conference of ISPS in NYC in March 2015 emphasizes dialogue, and why we hope you think about attending!

Lisa Dixon will be one of the plenary speakers at that conference.  She has been very active in the field, though people like myself wonder if some of her work hasn’t at times been more damaging that helpful – for example, that some of the “Assertive Community Treatment” and early intervention in psychosis she has been involved in might push drugs too hard, or that the Family to Family program within NAMI that Lisa has advocated for might have pushed a biological model in a dogmatic and unhelpful way.  Still, most would agree that many of her ideas are quite progressive, and some might like all of her ideas – and all of us might benefit from discussion about what works, and what doesn’t!

Here’s what the ISPS leadership had to say about Lisa:

We are so pleased to have Dr. Lisa Dixon as one of our plenary speakers.

Her work over the past 25 years has spanned wide areas of research and practice in psychosocial treatments for people with mental illness. She is currently the Director of the Center for Practice Innovations of the New York State Psychiatric Institute. The Center is a collaboration between Columbia University and the Office of Mental Health of New York State, and provides training and follow up support to NY agencies implementing evidence based practices for people with mental illness, such as assertive community treatment, the IPS model of supported employment, and wellness self management.

Recently she was also one of the principal researchers in NIMH’s Recovery After Initial Schizophrenic Episode (RAISE) study, and based on that research she initiated OnTrackNY, a new treatment program for teens and young adults experiencing a first psychotic episode. The program seeks to keep these young people out of the mainstream mental health system, utilizing a shared decision making model of treatment.

Prior to that, Dr. Dixon led a RCT research study confirming the effectiveness of NAMI’s Family-to-Family Program, which provides peer education, empowerment, and support.

Dr. Dixon has written and collaborated on over 200 articles in areas related to serious mental disorders: substance misuse, suicide, wellness, peer support, multi-family groups, recovery, smoking cessation, veterans and PTSD, diabetes and other medical problems, spirituality, sexuality, and stigma, as well as an appreciation of our esteemed ISPS colleague Wayne Fenton on his passing, in the October 2006 issue of Psychiatric Services.

For a listing and citations of Dr. Dixon’s work: 
See for information on the Center for Practice Innovations.

ISPS NY 2015     #isps2015nyc

Abstract submission deadline: October 1st 

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