Her father asked him to leave at once. “Jim, you don’t belong here, please go home.”
“Why don’t I belong here?” Jim said.
Mimi said nothing.
Lindsay bit her lip. It didn’t help. She lost it. She stood up and started screaming.
“You fucking asshole! You sexually abused me!”
Jim was not in good shape. His wife and son had left him, he was heavily medicated—and, per one of the side effects of the medication, well on his way to becoming obese. But he was not conceding anything, and he was more than willing to retaliate. He picked up a guitar that was lying around and broke it in half. He called Lindsay a liar, and he started yelling and screaming.
“That’s not true! You’re imagining things!”
But Jim could read the room. He saw no one was listening to him. And then he saw his father, telling him to get out and that he never wanted to see him there again.
Jim left. Lindsay spent the rest of the evening in tears. Her parents left her alone, heading back to the kitchen to do the dishes. Joe comforted her. “You’re not lying,” he said, holding her. “I know you’re not lying.”
That was what Lindsay would think of most in the years that followed—how her brother Joe believed her, and how her father had, too.
CHAPTER 27
New imaging equipment—including CAT and PET scanners—has demonstrated physiological differences in the brains of some schizophrenia patients. And now, using this and other technology, NIMH, under staff psychiatrist Lynn DeLisi, is attempting to identify a genetic marker in families where more than one member suffers from schizophrenia….
Both healthy and ill family members are needed for the study. Patients will continue to be treated by their regular physicians and participants will be paid.
Prospective participants may call Dr. Lynn DeLisi: 496-3465.
The Washington Post, July 20, 1984
From her seat at the long handmade wooden table in the kitchen on Hidden Valley Road, Lynn DeLisi saw at once the burden that Mimi had been bearing all these years.
Her husband was home and frail. He could help around the house and even drive, but each night he would go to bed wondering if he would remember what he’d read the next day.
Donald, the oldest, was home more or less all the time now, too. Three other sick sons, Joe, Peter, and Matt, roamed in and out of the house, between the hospital and home and their own apartments, which they’d inevitably leave or get tossed out of. Even Jim would wander by from time to time, too, before Don would notice him and demand that he leave.
The violence was a little less frequent these days. They were all getting older now, and they all were more consistently medicated. It was up to Mimi to keep them all active, manage their care, shuttle them to appointments, dispense their meds.
Given all that, DeLisi was amazed by the good cheer the Galvin matriarch displayed. “You can’t be heartbroken every day,” Mimi liked to say.
* * *
—
IN THE YEARS before Lynn DeLisi walked through the Galvins’ door, there was still no single theory of schizophrenia that was universally accepted. The precise mechanism of the disease remained a mystery, and many of the same nature-nurture battles continued. But without any great fanfare, some things were slowly changing.
After three decades, the schizophrenogenic mother theory was losing its hold. In 1982, an Australian psychiatrist named Gordon Parker published a review of schizophrenogenic-mother research in The Journal of Nervous and Mental Disease, concluding that, while distant and controlling mothers no doubt existed, there was no evidence that they were more likely than anyone else to have children with schizophrenia. The next year, Chestnut Lodge—the institution that, under the direction of Frieda Fromm-Reichmann, steadfastly ignored all calls to treat schizophrenia as a biological disorder—experienced a dramatic reversal. Thomas McGlashan, who had joined the hospital as a therapist in the 1970s, went public with a study of the case records of every patient treated there between 1950 and 1975. His conclusion: Only one third of Chestnut Lodge’s patients were moderately improved or recovered. If, like the psychoanalysts of Chestnut Lodge, you believed that the right course of therapy could cure almost any psychotic patient, a 33 percent success rate was not something to be proud of—especially not when the pharmaceutical industry was claiming a much higher success rate in treating the symptoms of psychosis. “Frieda…embarked on a grand experiment,” McGlashan said at the time. “The data is in. The experiment failed.”
After decades of debate, the thinking about schizophrenia seemed to be consolidating around the physical nature of the disease. On The Phil Donahue Show in 1983, the NIMH psychiatrist E. Fuller Torrey, promoting the publication of his book Surviving Schizophrenia, one of the most popular and influential books on the illness that decade and beyond, showed the audience images of CT scans of healthy brains, contrasted with brains with enlarged ventricles of schizophrenia patients. “That’s the brain disease you are looking at,” Torrey said. In a study published that same year, Torrey and his colleagues on Richard Wyatt’s team had ruled out neuroleptic medications as the cause of these larger ventricles; it was the illness, not the medication, that seemed to create this difference. Anyone who could not acknowledge now that schizophrenia was physical, he joked, must be a little behind in their reading. “Unfortunately there is a segment of the psychiatric community that reads only the National Geographic,” Torrey said. “They have not got the word yet.”
This was the age of biological psychiatry now, with psychopharmacology not far behind. The latest DSM—the DSM-III, published in 1980—had narrowed the diagnostic criteria of schizophrenia to seem less like the syndrome it was and more closely resemble a specific illness. Based on this new criteria, even Joanne Greenberg, the author of I Never Promised You a Rose Garden, was said to have been misdiagnosed at Chestnut Lodge. The delusional teenage girl did not have schizophrenia at all, a team of researchers declared in 1981, but merely suffered from an episode of somatization disorder, once known as hysteria—fleeting hallucinations coupled with acute but temporary physical pain. Schizophrenia’s star patient might not have been that sick to begin with.
It was a little too early, however, to declare victory in the nature-nurture war. With talk therapy on the ropes, neuroleptic drugs were ascendant. These drugs changed the lives of thousands of people, helping them create some space between themselves and their delusions. In the popular imagination, and even among many doctors, neuroleptics were considered revelatory, like insulin for diabetes. But how could that be when schizophrenia itself remained ragingly mysterious, and the drugs themselves could be physically damaging? The drugs made some patients obese, others stiff and ungainly, others practically catatonic—this from drugs that had been hailed as miracles. For the chronically mentally ill, success had been defined down to a point where it was starting to look a lot like failure.