<blockquote>
gardengirl: I looked up Depakote in the drug reference I use on my PDA, Epocrates. Psychosis and hallucinations are listed as possible serious reactions to the medication. Use of this med in pediatric populations requires extra caution. It's possible that the psychotic symptoms could be related to the Depakote, especially if those symptoms didn't start til after that was begun.

That's terrific that you looked up that info for MotherofThree, and it's good for her to know. I was quite surprised myself to discover that sometimes the drugs that are used to treat psychosis can actually cause psychosis. However, I did want to ask if you could provide a source of the quote. It's possible you already did ("PDA, Epocrates") and I simply didn't understand.

Also, I'm concerned that someone with a diagnosis of bipolar disorder, particularly a child, is taking Zoloft, an antidepressant. Folks with bipolar are more likely to respond to SSRI's with increased mania than those with unipolar depression. So it's possible that Zoloft if contributing to her symptoms by increasing her mania symptoms.

I think what concerns me most is the pattern of escalation and worsening of symptoms that Gemstone shared as part of her experience...

When I was a child (at around 12) I was dx'ed with depression and started on antidepressants. I had a negative response to the antidepressant and I became manic and suicidal and I was than dx'ed with bipolar 1 and started on a lot of other meds. Those meds made be groggy and drunk so I was dx'ed with add and given a stimulant to go along with all the sedatives.

In my case I was being severely abused and was very dissociative. I was depressed, but no amount of anti-depressants would have fixed me.

There is always a human element that too often, gets overlooked in the neurology of theory. I've spent the last few years talking to people who have gone through an episode of psychosis and in every instance there was a triggering factor. Sometimes, it's one that's easily resolved such as recreational drug use; other times it's more complex, such as trauma. What all of these people seem to need is first of all, a place of safety -- they need a safe environment. The second thing they need is to be with people they can feel safe with. Often, this is family members or friends, sometimes it's a professional -- the "rank" doesn't seem to be near as important as the empathic human connection. The third thing they seem to need is to express what they're going through, to "get it out" of their system...

<hr width=100% size=2>

<blockquote><font color=191970>An Interview With Dr. John Weir Perry</a>

<center><font color=red>"...85% of our clients (all diagnosed as severely schizophrenic) at the Diabasis center not only improved, with no medications, but most went on growing after leaving us."</font></center>

O'C: In your book The Far Side of Madness, you describe how at Diabasis - the home for "schizophrenic" individuals which you set up - they could comfortably get into their visionary process in a totally supportive atmosphere. What are the necessary conditions to enable a person to go through the experience of madness and be renewed by it when they come through, as you put it, on the far side?

PERRY: That's a question with many facets! The first one, which we touched on briefly toward the beginning of this conversation, was about the conditions that are set up around such an individual. What we did at Diabasis was specifically to set up what we hoped would be the most ideal, least toxic (smile), least damaging environment for a person in the visionary state.

First off, this means a home. You need a place with friendly, sympathetic individuals who live there. These people have to be companions, have to be willing to listen and not be frightened and not be judgmental about it, and not try to do anything to anybody.

One has to let the visionary process unfold itself spontaneously. Under such conditions, to our surprise, we found that our clients got into a clear space very quickly! We had started out with the notion that we would surely be in for alot of bedlam with all this "madness" going on, but actually the opposite was true! People would come in just as crazy as could be on the first day or two, but they'd settle down very soon into a state of coherency and clarity. Often, when I would come in for a consultation at the end of the week, I would see someone who had been admitted in a completely freaked-out state just a few days before, sitting at the dinner-table indistinguishable from anybody else; sometimes I couldn't tell if this was a new member of the staff, or one of our clients. The calming effect of a supportive environment is truly amazing!

It's a well-known fact that people can and do clear up in a benign setting. Actually, they can come down very quickly. But if some of our cases had gone to the mental hospital, they would have been given a very dire message: "You've had a mental breakdown. You're sick. You're into this for decades, maybe for the rest of your life!" and told "You need this medication to keep it all together." I am quite certain that if some of our clients had been sent to the mental hospital, they would have had a long, long fight with it. The outcome of their stay at Diabasis, however, was that their life after the episode was substantially more satisfying and fulfilling to them than it had been before!

O'C: Would the determining factor then be the person's realisation that she is in a non-ordinary state of consciousness - i.e. a state which, although very different from that of the people around her, is in fact completely natural and good - and that the hallucinatory imagery carries a symbolic meaning, which pertains primarily to the inner reality, rather than to the outside world?

PERRY: You said it! The tendency, as you suggest, is to concretise all the symbolic stuff and believe there are enemies out there, and that the walls are wired, that there are people with guns at the window, and subversive political parties trying to do things, or that one is being watched because one is the head of some organisation and everybody knows it. All of that is a mistaken, "concretistic" tendency to take too literally things whose correct meaning is actually symbolic.

So yes, the therapeutic goal is to achieve that attitude which perceives the symbolic nature of the ideation which belongs to the inner reality. Now the inner reality is real! It's very important to grant it that reality, but not to get the two realities mixed up. That's the trick! Actually, for most people it's surprisingly easy. Certainly, the more paranoid a person is, the more difficult. There is a certain paranoid makeup, a style of personality which tends to focus on the objective world around. It's what we call an attention style. It is difficult for such people to see the inner meaning of their visions. On the other hand, the average person tends to go along with the inner journey and to realise - well, they do need to be reminded - but once they're reminded, they tend to quickly perceive that it is a spiritual test, or a symbolic test, and not the actual end of the actual world.

The second condition needed for a successful outcome of the "schizophrenic episode" is not just a benign surround, but also some people who can relate to the visionary process in a sympathetic way. I believe very strongly that it's not just enough to have a benign community around such a person: the thing that really makes the process move and reach its conclusion, is an intense relationship with one or two people. Sometimes with a man and a woman, who may play a symbolic role like two parents, or like the opposites, which can be taken care of in this way.

Bringing the whole supercharged process into a relationship seems to make it bearable, containable, manageable. Of course, some people go through it alone. They tell me this is highly painful, very frightening. But if one has a therapist or counsellor to whom one can relate the experience, one need not suffer a whole lot once the process gets underway. There will always be some tough moments, nightmarish times, bewilderment. One wonders what the dangers are, whether there are evil forces out there. But through these weeks, somehow, the prevailing mood is actually one of buoyancy. At Diabasis, there was a general atmosphere of jocularity. People would be joking around, having fun, playing music and dancing and humming tunes and painting...

O'C: Yes, in fact wasn't that part of the design? You had all sorts of ways for people to communicate their experience and externalise in through various forms of art?

PERRY: The whole environment was organised into various "spaces." One of these - a very important one - was called the rage room. This was sound-proofed and padded, for the individual's own protection, and we put things in there that they could whack to pieces like old cottons and mattresses. But the door was not locked, it was not like the padded cell in the mental hospital, where the person is isolated against his will... We set it up so that if a client was having strong feelings of rage, he or she could share it with a staff member, particularly the counsellor or primary therapist, and thus deliver it. This was found meaningful. The anger is a very important part of the growth of the ego, you see.

We also had the opposite: a room for quietness and meditation. This was equally important, for integrative purposes. We had an art room, but I must say, people didn't seem to spend much time there (chuckle). These so-called "sensitive personalities" were all hanging around the dining room table, doing water-colours or modelling in clay, and giving creative expression to some of the imagery inside their head. We also had a sand tray and figurines for sandplay therapy. It works like a dream: you set up a dramatic scene, move the figurines, tell a story. This avenue of expression is easier than painting. It's very dreamlike, so it hits the visionary state very well. We also had poetry...

Another thing we provided was a variety of body movement sessions, dance and martial arts, with skilled facilitators. And finally, we had interviews at least three of four times a week, for an hour and a half to two hours each, with the primary counsellor/therapist. But really all of these creative outlets put together became part of the interview itself - verbal expression combined with image expression in these various media.

Now throughout all this there was nothing scheduled, nothing mandatory. It was all informal. We'd just respond to things as they came up. Our only house rule really was "No violence to property or persons!" The clients could dash out nude into the street if they had to; we didn't like it, but they did! You see, we wanted them to be in this house of their own free will. They had to realise their own desire to belong in the house, and they did.

So this whole approach is essentially one of releasing, rather than suppression. We allowed everything and encouraged its expression - not toward chaos, but toward communication! Communication tends to order. This is a most important point in psychiatry, but the common opinion is that it is very dangerous... When you actually do it, however, you find exactly the opposite is true: people get over their preoccupations very quickly. The whole point here is to deliver the visionary content to somebody and to be able to appreciate its symbolic relevance to the inner process of personal and social renewal. Once it's delivered, the process keeps moving by itself. It's really unfortunate there is so much misunderstanding about it all. The truth is really very simple.

Source: An Interview With John Weir Perry

See also: Mental Breakdown as Healing

</blockquote>