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teejai: I personally support the medical model approach to a degree(Antipsychotics work with a varying degree of success but are not the 'magic bullet' that some would laud them to be) though not with the avid rabidity of some. Where i draw the line is with the overemphasis on medicine as a solution at the exclusion or playing down of other approaches.

About a week ago I got into a discussion with someone in relation to Roky Erickson. Roky was a talented musician who shot to stardom with a hit single You're Gonna Miss Me. A front man for the band 13th Floor Elevators, he was considered to be the creator of psychedelic music and the muse of Janis Joplin.

It was the 60's and then, as now, numerous drugs were available to those doing the star circuit. Roky apparently did a lot of drugs. In 1968 he was arrested for possession of one joint. The legal system thought they'd make an example out of him and were calling for ten years of hard labor. Given all the drugs he'd taken over the years, his lawyer thought he could make a good case for an insanity plea. The plan backfired.

Roky was sent to the Rusk State Mental Hospital for the Criminally Insane where he received multiple electroshock treatments and thorazine. By the time he emerged, three years later, friends say he was a changed man.

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Clementine Hall blames electroshock treatments, done against Erickson's will at Houston's Hedgecroft Hospital, for making Erickson snap. "Roky escaped from Hedgecroft and Tommy brought him to stay with me in San Francisco," Hall said. "He was different. He said the Russians were talking to him through his teeth and that they wanted him to do bad things." In the documentary, Clementine Hall talks about taking Erickson to the beach and letting waves crash into him, the only thing that would quiet the voices.

Source: The Comeback of Roky Erickson


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Roky was eventually released into his mother's care. He didn't want to take medication and she supported him in his decision. I'm not clear on her motives, it may have been related to the treatment he'd already received. Roky spiralled downwards and was pretty much forgotten on the music scene until a journalist decided to hunt him down for a documentary.

In the course of the filming that spanned a few years, one of Roky's brothers successfully challenged his mother's custody. Roky's care was transferred to his brother and for the first time in many years, he began to receive drug treatment.

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"It's really a miracle," said younger brother Sumner Erickson, who was awarded legal guardianship of Roky from their mother, Evelyn, in a 2001 court decision. Roky Erickson was in a badly deteriorated state at the time, a junk-mail packrat with rotted, abscessed teeth and a need to sit between walls of white noise to make the voices inside his head go away. Diagnosed as a paranoid schizophrenic, Erickson refused to take medication, a decision his mother supported.

For decades, a bearded, wild-eyed Erickson wouldn't let anyone touch him, but at his London debut in April, he leaned over the rim of the stage to shake fans' hands and afterward spent two hours signing autographs and posing for pictures.

Source: The Comeback of Roky Erickson


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In the course of the discussion that unfolded, one of the participants noted: This reinforces, my opinion, that medication can be an opening to life when living without it takes away what makes life worth living for a person.

And he's right, but he's also wrong because it wasn't just medication that made a difference to Roky's life. I noted at that time...

<blockquote>I'm going to take a bit of a different stance. I read this great statement somewhere that medication encourages "magical thinking" and this is because the impression that so many people have of medication is that it's a magic bullet -- give a schizophrenic medication and it's all uphill from there. It is true that medication certainly helps some people, but for others it makes things worse. There's also the issue of compliancy and side effects. For example, in the recent CATIE study, 74% of the participants dropped out of the study because they could not tolerate the side effects of the drugs. While the older drugs were more likely to create neurological dysfunction the newer atypicals seem more likely to create metabolical dysfunction, such as diabetes, obesity and pulmonary complications. And let's not get into the expense of the new atypicals which have not been proven to be any more effective than the older, much more affordable drugs.

Did medical treatment help Roky? Yes, I think his experience is a testament to good treatment, but his personal history also demonstrates the results of bad treatment. Psychiatry has its dark side and no where is it darker than in the treatment of schizophrenia.

I think what really made a difference in Roky's recovery is other people, beginning with the journalist. Whatever dynamic had been at play in Roky's family relationships had been going on for decades and likely would have continued until his death. Perhaps what prompted his brother to challenge his mother was that investigative eye looking in upon the wreckage that shouldn't have been. It appears that the documentary itself reconnected Roky to his former identity and then, along with plenty of support, encouragement, non-coercion, therapy, the re-establishment of personal meaning and purpose, medical care, and medication, he began to move into recovery. Medication alone didn't produce that although it certainly appears to have assisted. As I understand it, Roky's no longer on medication and he is still doing well. Good on him, is all I can say.

Personally, this story demonstrates the way I think medication should be used and that's only when necessary for as short a term as possible to assist the individual to get back on their feet. We know that over the long term, and even over the short term, anti-psychotic medication can produce results that there is no recovery from. It is one tool of many and should be used sparingly. But too many think it's the only tool.

In other words, although we might agree to disagree in other areas, I think we're in firm agreement on this one.

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