The One You Feed - A Story of Friendship and Mental Illness with Jonathan Rosen

Episode Date: August 20, 2024

In this episode, Jonathan Rosen shares a deeply personal journey of friendship and mental illness, shedding light on his best friend, Michael’s battle with schizophrenia. Through his poignant storyt...elling, Jonathan delves into the challenges Michael faced, the complexities of the mental healthcare system, and the societal misconceptions surrounding mental illness. He captures the emotional turmoil and thought-provoking reflections on the cultural and personal dimensions of this devasting mental illness. In this episode, you will be able to: Discover the transformative power of a morning gratitude ritual and its impact on mental well-being Explore heartwarming friendship stories that shed light on navigating mental illness with support and understanding Gain insight into a personal journey with schizophrenia, understanding the challenges and triumphs Uncover the far-reaching impacts of deinstitutionalization on mental health and society as a whole Navigate the complex landscape of mental health legal dilemmas and the implications for individuals and communities To learn more, click here!See omnystudio.com/listener for privacy information.

Transcript
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Starting point is 00:00:00 the chances of harm coming to you or someone else simply because you are starting from an irrational point of view, however rationally you now carry it forward, is high. Welcome to The One You Feed. Throughout time, great thinkers have recognized the importance of the thoughts we have. Quotes like garbage in, garbage out, or you are what you think ring true. And yet, for many of us, our thoughts don't strengthen or empower us. We tend toward negativity, self-pity, jealousy, or fear. We see what we don't have instead of what we do.
Starting point is 00:00:45 We think things that hold us back and dampen our spirit. But it's not just about thinking. Our actions matter. It takes conscious, consistent, and creative effort to make a life worth living. This podcast is about how other people keep themselves moving in the right direction. How they feed their good wolf. Wolf. I'm Jason Alexander. And I'm Peter Tilden. And together, our mission on the Really No Really podcast is to get the true answers to life's baffling
Starting point is 00:01:23 questions like, why the bathroom door doesn't go all the way to the floor. Is to get the true answers to life's baffling questions like. Why the bathroom door doesn't go all the way to the floor. What's in the museum of failure and does your dog truly love you? We have the answer. Go to reallyknowreally.com. And register to win $500, a guest spot on our podcast or a limited edition signed Jason bobblehead. The Really Know Really podcast. Follow us on the iHeartRadio app, Apple podcasts or wherever you get your podcasts. Thanks for joining us. Our guest on this episode is Jonathan Rosen, an American author and editor.
Starting point is 00:01:51 Rosen graduated from Yale and is the author of many books, including Joy Comes in the Morning and the book discussed here with Eric, The Best Minds, a story of friendship, madness, and the tragedy of goodions. It's a memoir about his friendship with Michael Laudor, a Yale School graduate with schizophrenia who killed his fiance in 1998 during a psychotic episode. The book was a finalist for the Pulitzer Prize. Hi, Jonathan. Welcome to the show. Hi. Nice to be here. I'm excited to have you on. We're going to be discussing your book,
Starting point is 00:02:30 which is called The Best Minds, a story of friendship, madness, and the tragedy of good intentions. And it's an outstanding book, and we'll be getting to it in a moment, but we'll start like we always do with the parable. In the parable, there's a grandparent who's talking with their grandchild, and they say in life, there are two wolves inside of us that are always at battle. One's a good wolf, which represents things like kindness and bravery and love. And the other is a bad wolf, which represents things like greed and hatred and fear. And the grandchild stops, and they think about it for a second, and they look up at their grandparent, and they say, well, which one wins? And the grandparent says, the one you feed. So I'd like to start off by asking you what that parable means to you in
Starting point is 00:03:11 your life and in the work that you do. First of all, I love parables. So I love it that you begin with one. I also love it that in the parable, both wolves are present. Everyone has them both within. Many years ago, like 24 years ago, I wrote a book called The Talmud and the Internet, which was about joining unlikely things. And at one point, I tell a story from the Talmud, which is this ancient codified book of Jewish law and story. And the rabbis ask a question, does God pray? And the answer is yes. So the question then becomes, what does God pray? And God prays, may it be my will that my mercy is greater than my anger, so that my attribute of mercy will overwhelm my attribute of judgment, and I can approach my children mercifully. So what I love
Starting point is 00:04:07 about that is that even God prays for more mercy than anger, and God is omnipotent. But I guess in Judaism, since you're created in the image of God, that's not anthropomorphizing God, that's theomorphizing people. Even we do this divine thing, which is hope that our mercy is greater than our anger. But it doesn't mean that anger can ever be eliminated, nor necessarily even should it. So I think what it makes me think about in my own work is how many times I've been drawn to twins, to pairings. And you're not always sure what the proportions are of those or what the differences are. And certainly, The Best Minds is about my childhood best friend who literally lived across the street from me. So we were always twinned, even though, of course, within each of us were
Starting point is 00:04:57 these attributes. We didn't each represent a principle. I think you're the first person to ever use the term theomorphizing in 700 episodes of this show or so. I'm not sure I've ever heard it before. I understood it the minute you used it, but I'm not sure that's a word I've ever heard before. Yeah, I must have heard it before. And I think it's one of those things that is an explanation for the mysterious strangeness of being made in the image of God. We're always trying to figure out what that means. But if we are theomorphic, then that means we ourselves have within us some image of God. And therefore, our behavior is bound up with not only at odds with some divine
Starting point is 00:05:40 ideal. Before we get into the book, one of the things that I've heard you say before about your Jewish faith is that there's one practice that you do every morning. And it's sort of the thing that you feel like you're most consistent with in a life that's not very adherent to the rest of Jewish law. What is that thing? When I wake up, I say the morning prayer. And the morning prayer is thanking God for giving you back your soul. Who returns my soul to me in loving kindness. So it allows you to begin the day with gratitude. And in fact, the instruction for that prayer in the Shulchan Aruch, this medieval code, which tells you the order of prayers and things, says you should awake to say the prayer with a lion-like resolve to do God's will.
Starting point is 00:06:33 A lion-like resolve. I like that. And then, of course, it's all newspapers and anxiety. But at least I have my morning island in which I try to acknowledge how mysterious and wonderful it is that I'm alive. Yeah. Yep. So your book, again, the title is The Best Minds, The Story of Friendship, Madness, and the Tragedy of Good Intentions. Boy, are good intentions that go wrong always so tragic, too. Yeah.
Starting point is 00:07:00 And it's a book about, you referenced a little bit, a childhood friend of yours who, I'm just going to give the whole thing away here, goes on to develop a severe mental illness, whether that be the counterculture that became the main culture, whether that be literature, whether that be the law, whether that be psychiatry itself. I mean, all these things weave together in this really interesting tapestry. But why don't we start by having you just describe your friend, Michael, and what your childhood roughly was like. Sure. So I grew up in New Rochelle, which is a Westchester suburb of New York City. We moved there in 1973. I was 10 years old. I lived on a very short street, had about seven houses, and Michael lived across the street and down a few houses. And I met him the day I moved in pretty much. He was very precocious. He was very tall. His nickname was Big. And also Toes, because he was always like leaning upward and forward,
Starting point is 00:08:12 whereas I was very shy. And so although I was almost as tall as he was, nobody called me Big. He also was brilliant. He read incredibly fast, and he had a photographic memory. I was dyslexic, although I didn't know it then. It wasn't identified. But still, we were both going to be writers. And so we were very competitive and very, very close. And we were inseparable for many years. And we both went to Yale.
Starting point is 00:08:39 Michael graduated in three years because that was his way as summa cum laude. And then he went to work for a management consulting firm. His plan was to work for 10 years, make a lot of money, retire and write. And when he got hired, it was just the beginning in the 80s when people came to recruit you for management consulting. It was almost a new thing. And as he himself said, they wanted people like him who could talk with enormous conviction about things they knew nothing about. And he was masterful at that. So he was doing all that. And then already within the he knew, in a sense, that these things he was seeing and experiencing were anything other than this strange, weird world that he was kind of accepting. weird world that he was kind of accepting. And in fact, I was jealous because he quit after just a year and was living in the attic of this grand house in New Rochelle owned by two psychiatrists with a view of the water and was writing stories. And I was a grad student and I thought, oh,
Starting point is 00:09:54 he's got the jump on me. He's writing stories. But then he began to really become delusional. He thought his parents had been replaced by Nazi replicas who looked just like his parents. And so he began patrolling the house with a kitchen knife and his mother called the police and he was in a locked ward for eight months. And that was his break. The amazing thing about him though, and this is just in keeping with who he was, is that while he was still in a halfway house, before his break, he had applied to law school, all the top law schools. While he was, is that while he was still in a halfway house, before his break, he had applied to law school, all the top law schools. While he was in the locked ward, he got into all of them. His brother, on his behalf, turned them all down except for Yale, which he deferred. And while he
Starting point is 00:10:35 was in the halfway house, he decided, I'm going to go to Yale Law School and did. Yes. And this is where things in the story start to get very interesting. And I read the story like we all do by seeing things through our own lenses. And I have a lens of around the age you and Michael were at this point, maybe a little bit older, but not by much of being a homeless heroin addict who was in long term treatment and then in a halfway house and trying to rebuild a life after that. And so it was very interesting for me to sort of look at Michael's journey and mine, and they're very, very different, right? Like I would, I mean, I never went to college at all, let alone Yale and graduate in three years. Lucky for you. Maybe so, yeah, in that case. But what I was struck by was this idea that the halfway house felt very demeaning and beneath him. And I felt that way, certainly, at points with that, right?
Starting point is 00:11:36 We had this saying, though, early on in recovery, and I never really liked it, but I understood it. In essence, it was, you can't be too dumb to get sober, but you can be too smart. And I thought about that a lot, right, in this book, because in many ways, Michael's huge intelligence and gifts were not gifts or benefits in the battle he was in against mental illness. Yeah. And I'd actually go even farther. When we were growing up, being smart was enormously important. Didn't even really know what it meant and certainly didn't know what you were going to do with it. You didn't want to be smart so you could invent something helpful to make people's
Starting point is 00:12:20 lives better. It was just like you would be inoculated against all the ills or sorrows of the world. And it was, as I say in the book, we were like our brain was going to be our rocket ship. And it went without saying, we were going to climb in and just blast off. And later, of course, I came to think about just how destructive that was as an idea. And Michael used to say something that was almost the opposite of the saying in Your Halfway House. He would say, I may be crazy, but I'm not stupid. And he found himself in an environment in which brilliance was recognized just as we had thought about it. And although he could not actually do the work at Yale Law School, he was known or seen as brilliant, and that was somehow going to be the means of his salvation. Whereas, in fact, what he needed was what a traditional asylum would grant you, space and time. And somehow, when the doctors and the halfway house suggested that he do something that at the beginning would be more basic, despite his brilliance, like work in Macy's or a grocery store, so he could recover what he lost, however much he could, and then move to
Starting point is 00:13:30 another level. His family felt, and he felt, that it was enormously demeaning. And then because he'd already gotten into Yale before his break, he would say, why would I bag groceries when I could be a Yale lawyer? The tragedy of the subtitle is that one of his professors said to me, he never thought Michael was going to be a Yale lawyer. He thought Michael was going to be someone who had gone to Yale Law School and might therefore be a spokesperson for people with severe mental illness. So already, Michael's understanding of himself and why he was there was different. And since the space between reality and how he perceived it was the very nature of his illness, they were actually widening that gap. In their minds,
Starting point is 00:14:10 they were accommodating him, but it was like they were rhetorically accommodating him. And although they granted him what was like a kind of asylum for him for a while, it's a green interior with walls around it and people were very kind to him. But there was no actual provision for his recovery or for his future there. Yeah, there's a line that says it also went without saying that Macy's would destroy him and Yale Law School would set him free. I believed it. My parents and Michael's parents believed it. So did Guido Calabresi, who was the dean there at the time and the professors who became his mentors, right? Everybody believed this is the best thing for him. And none of us know what would happen if the story had gone differently,
Starting point is 00:14:51 right? We can't know that. But to your point, what happened was he got that Yale Law School, which then led to a profile in the New York Times of the genius who has basically, in the New York Times of the genius who has basically, in spite of schizophrenia, still gotten into Yale Law School and is this incredible, amazing person, which led to a book deal, which led to a movie deal, and led in many ways to him being in a profession that is very challenging for even the mentally stable, which is to be alone on your own writing books. Yeah. If you made a list of all the things you shouldn't do, if you're trying to recover from a psychotic break, he did them all. You know, being alone for long portions of the day, enormous pressure to write a book that in a sense he couldn't write because it wasn't quite his story.
Starting point is 00:15:46 And that's also something that has haunted me because my mother is a writer. I grew up loving stories. I do love stories. But you can be trapped in a story. You can be trapped in other people's stories. And you mentioned my interest in the role the culture might have played. You spoke about how Michael killed the person he loved most in the world, his fiance. It never felt like a spoiler to me to say that, because it always felt like a murder mystery. Not just why him, why not me, even though I knew he did it, but also how was it that there were not places for him when he needed them? What had happened to the systems that were supposed to care for him? And more than that, how had it happened that people had developed an artificial understanding of what psychosis
Starting point is 00:16:30 might be? How had it become almost romanticized? And one of the things I like to remind people is that in the 50s, antipsychotic medication, which was a revolution for people who were with psychosis, was introduced the same year as LSD. And they were both given to psychiatrists to figure out, you know. So you had people with a drug in one hand that suppressed delusions and hallucinations and a drug in the other hand that induced them. And the culture pretty much decided inducing hallucinations was mind-expanding, and that therefore those people who naturally hallucinated must be like prophets or priests. And so it immediately spilled over from the medical into the cultural, and then the cultural transformed the law, and then the law reinforced
Starting point is 00:17:17 the culture. And so pretty soon, all the ways of understanding illness as an illness had fallen away, sometimes even inverting its meaning. And tracing that backwards was a revelation for me. And since he was literally lived in a house with psychiatrists who provided his care and were of the 60s community mental health movement, and then he was in Yale Law School where his mentors were law professors who had clerked for the very judges who had changed the institutionalization laws. Every place he went was almost emblematic, even though it was actually real at the same time. So I'm not sure where I started my sentence. I've ended somewhere.
Starting point is 00:17:59 There's a lot in there to sort of tweeze apart. And let's start with the deinstitutionalization process. Talk to me about when of the two wolves, that I was incredibly angry. I was angry at all of these smart people who seemed to have made so many dreadful decisions. But what I decided to do was tell my book from childhood forward, not backwards like a journalist. So it wasn't going to be a tragic inevitability and how did everybody cause it? It was really going to be people actually making decisions in real time, just like I live my life in real time. So during the Second World War, first of all, there seemed to be a mental health crisis. Several million people were found unfit for service or were released from service for psychiatric reasons. Some of them had what was
Starting point is 00:19:00 then called shell shock, but that allowed in the aftermath of the war, people to think, oh my God, we have to address this. Meanwhile, state hospitals had fallen into a dreadful state, partly because half the staff had been drafted, partly because of the wars, they were now bursting with people, partly because people lived longer. And so instead of just younger people suffering from illnesses, there were older people who had dementia. So instead of just younger people suffering from illnesses, there were older people who had dementia. And those people really were only heading in one direction. 20% of all the people who have a psychotic break and an accurate diagnosis of schizophrenia never have another break. So the character of these places had changed, and they were huge. They were like medieval villages.
Starting point is 00:19:39 They had farms and theaters, and people worked in the soil. And all of this was devised before there were any medications. It was called moral care. But when you looked at it and Life magazine ran pictures of naked people huddled together, it looked as much like a concentration camp that had been liberated and Life had run those pictures not long before as it did like anything else. So the desire not to reform them, but just to like tear them down was very great. Meanwhile, antipsychotic medication came along and lots of people who were there shouldn't have been there. So many people could be released. But then what happened was partly President
Starting point is 00:20:16 Kennedy, the last piece of major legislation he signed into law before he was assassinated was the Community Mental Health Act. And as he's put it, no longer should the cold custodial care of the asylum imprison people when we could have the warmth of community care. Problem is nobody had figured out what community care would mean. And more than that, hospitals were for a very specific, small percentage of the population who were extremely sick. Community mental health centers didn't just replace the word like a psychiatric disorder with the word mental illness, which itself became a vast category far beyond the limits of its small particularity. It used the word health and its goal was to make everybody healthier. And the one group of people who were not cared for were severely ill people because they often didn't see themselves as sick.
Starting point is 00:21:10 It was a symptom of their illness. And they required a tremendous amount of care and attention. So instead, they were either turned away or never showed up. Some went home. Many wound up on the street. Many wound up in prison. many wound up in prison. They were re-institutionalized, not de-institutionalized, because what people had fantasized would take the place of state hospitals, community care,
Starting point is 00:21:35 helped everyone but the one group of people in whose name they'd been created. That's a very cartoonish and truncated version, but it took me 10 years to write the book, so I'd like to spare everyone a small portion of that time. I'm Jason Alexander. And I'm Peter Tilden. And together on the Really No Really podcast, our mission is to get the true answers to life's baffling questions like why they refuse to make the bathroom door go all the way to the floor. We got the answer. Will space junk block your cell signal?
Starting point is 00:22:16 The astronaut who almost drowned during a spacewalk gives us the answer. We talk with the scientist who figured out if your dog truly loves you and the one bringing back the woolly mammoth. Plus, does Tom Cruise really do his own stunts? His stuntman reveals the answer. And you never know who's going to drop by. Mr. Bryan Cranston is with us today. How are you, too?
Starting point is 00:22:35 Hello, my friend. Wayne Knight about Jurassic Park. Wayne Knight, welcome to Really, No Really, sir. Bless you all. Hello, Newman. And you never know when Howie Mandel might just stop by to talk about judging. Really? That's the opening? Really, no really. Yeah, really.
Starting point is 00:22:49 No really. Go to reallynoreally.com. And register to win $500, a guest spot on our podcast, or a limited edition signed Jason bobblehead. It's called Really, No Really, and you can find it on the iHeartRadio app, on Apple Podcasts, or wherever you get your podcasts. There's another thing that's happening alongside this. There's probably many things, but the other one is that we are moving from the idea of psychiatry being for the truly,
Starting point is 00:23:20 extremely mentally ill to the rest of us, which Freud called, what was it, the psychopathology of daily living? Of everyday life, yeah. Or it could have been the translated volume. Yes, the psychopathology of everyday life. That was an enormous revolution that had already taken place in psychiatry. So Freud died in, I don't know, 39, I think. He never treated people with psychotic disorders like bipolar disorder or schizophrenia, but he drew from their experiences the way he drew from his own dreams. And this was something I kept discovering. People kept borrowing almost
Starting point is 00:23:59 the metaphor of severe illness and redistributing it to everyone. So if everybody suffers from the psychopathology of everyday life, then instead of living in a giant rustic asylum where your only patients are severely ill people, you can have an office, you know, on Fifth Avenue, like a dentist with normal hours and send your kids to private school. So the first group of people to be deinstitutionalized were psychiatrists. They kind of got themselves out. And that did two things. It left behind those who most needed psychiatric attention, but it also sort of universalized a state of illness as if the default wasn't that you're well, but that you're ill. And you require psychiatric attention just to enter what Freud would call ordinary unhappiness.
Starting point is 00:24:46 It's one of the reasons I write about myself personally, because first of all, when I was a teenager and Michael was getting sick, you never feel normal. And second of all, because I certainly struggled with plenty of things that would now be in the DSM, the psychiatrist's guide. And I thought, well, if I decided to take Prozac, I would not want people to force me to take it. And I wouldn't want anyone to tell me I had to stop taking it. And so I thought of myself as being in the same category, not that I was in any way remotely, like thinking your parents had been replaced by Nazi replicas, and therefore you have to arm yourself to defend yourself. But nobody explained
Starting point is 00:25:26 any of those things. There was just this giant fungible notion of mental illness. That doesn't mean ordinary suffering is not intense. And many people with depression are under-medicated, despite the way we talk about over-medication, and under-treated. Nevertheless, it allowed for a confusion that I participated in. And I kind of wanted to acknowledge that so I could think about it more clearly, because I think it's hard to retreat from that position now. Yeah, I mean, I think we all have, right? I mean, I think we all have expanded what mental illness, mental health is, and an attempt to de-stigmatize, which I think we're going to come around to at some point.
Starting point is 00:26:07 de-stigmatize, which I think we're going to come around to at some point, we did lose this idea that there are some people, schizophrenics, bipolar being the main ones. I mean, we can call it the same as anxiety or depression in that it's an illness that affects your mental state. But like you said, it's very different to be worried about whether you're going to pass all your classes versus thinking your parents are Nazis. Those are pretty diametrically different problems to be worried about whether you're going to pass all your classes versus thinking your parents are Nazis. Those are pretty diametrically different problems to be having. That's right. It's interesting. You've talked and had people on the program before talking about the elephant of emotions. Actually, John Haidt, who I think used that initial metaphor, was my class at Yale. But what was amazing to me about Michael's illness was that he was intensely rational, but he would be making rational conclusions based on an entirely irrational premise. If you think your parents are Nazis, it actually makes sense to arm yourself.
Starting point is 00:26:56 And the question of whether you're dangerous or not is not the properly phrased question. properly phrased question. The chances of harm coming to you or someone else simply because you are starting from an irrational point of view, however rationally you now carry it forward, is high. And that took a very long time for me to understand. Many people think that to be psychotic is to simply be entirely irrational in every aspect of your being. And that, I think, made it much harder for people to recognize that Michael was ill, even though he actually told his professors about his hallucinations. And at one point, the dean of Yale Law School, who you mentioned, called his daughter, who I knew and who was at that very moment studying to be a psychiatrist and working with a homeless, mentally
Starting point is 00:27:40 ill population. Michael had told this dean that he saw him in the morning sitting on his bed surrounded by flames and thought he was the devil. The dean told his daughter this story as if it were a kind of amusing instance of what he called neurosis. And his daughter said, dad, you have no idea what you're talking about. And yet people in that position had all changed the laws that made it very, very difficult to get someone help when they required it and not able to help themselves. And that became a real tangle. We're still untangling that knot. Yeah.
Starting point is 00:28:12 I mean, the other tragedy of good intentions, I think, I mean, there's lots of them, right? Deinstitutionalization, a tragedy of good intentions, right? The people who did that, President Kennedy and the people that he was working with had very good intentions. But it's also interesting that in addition to the people at Yale Law School who perhaps helped Michael in ways that didn't end up being helpful, is the fact that he was surrounded by psychiatrists. That's the other amazing thing as you hear the story. And there's the occasional lone voice among the psychiatrists, like the Dean's daughter, who are saying like, hang on, like there's a real problem here and you guys are ignoring it. And other people going, well, no, things seem okay. I think,
Starting point is 00:28:57 I think it's okay. And the good intention that people have is they don't want to interfere in someone else's life or take away their autonomy, you know, forcing somebody, as you alluded to, to take their medication, to confine someone against their will. These all seem like really bad things, except when the alternative is perhaps even worse. He was surrounded by people who were convinced they were honoring his autonomy, as you say, and instead they were facilitating his illness and they were putting his girlfriend in harm's way as well. And that truly was tragic. Their goal, the psychiatrist's goal, was to save him from the system much more than they wanted to save him from the worst effects of his illness.
Starting point is 00:29:46 And again, they were formed at a time when the system really sucked. It was very bad, but that it overshadowed the reality of his illness was a kind of, it wasn't a mass delusion. It was the product of many elements, including by the way, the idea, and I fell victim to it myself. If you're telling your story, and he sold his story for a lot of money, and you're going to be in a movie and Brad Pitt is going to play you, and Brad Pitt was going to play him, then you feel, well, he has indeed succeeded. So when the dean said at the end of the New York Times profile, he's conquered his illness. Although it's not an illness you conquer, it invoked a story that is deeply appealing. Michael's the person who had told me about The Hero with a Thousand Faces, a book I loved by Joseph Campbell, that the hero goes out into
Starting point is 00:30:35 the world, is wounded, but somehow gathers the strength, is helped by, you know, like supernatural creatures, and then survives and maybe limps, has a wound, but has gifts to give the world. And Joseph Campbell even wrote an essay in the grip of this cultural moment called The Schizophrenic Journey. And he described the schizophrenic person just like the hero. Let the traveler go. In other words, don't medicate this person. We now know, of course, that the sooner you can stop a cycle of psychosis, the better the recovery is, the less damage is done. But let the traveler go. They still believed perhaps that there was going to be some transcendent reward for everyone. As a later dean of Yale Law School who knew Michael said to me, he said, if I'd spent less time thinking what a wonderful place Yale is for having taken Michael and more time wondering what his actual experience
Starting point is 00:31:30 was, I think it would have been better for him. Yeah. You just touched on that idea of telling our story. You say Freud had borrowed freely from literature for his new science, but he gave it back the idea that telling a story was an act of healing. And it's interesting because telling stories can be an act of healing. No question. Right? 12-step programs are based on that to a very large degree and hearing other people's stories. But you say you would have to be very ignorant about schizophrenia, as I certainly was, and
Starting point is 00:32:03 deluded about writing, as I continued to be, to think that telling the story of your struggle with psychosis could turn it into a past tense affliction, like sorrow transmuted into words. And I think that past tense affliction is a really interesting way of saying it. Because 25 years out from opioid addiction, I tell my story and it has been a way of healing for me. And I think it's been a way of many people also hearing it and helping, but I under no way, shape or form think that I suddenly now could use heroin safely, right? Like it's past tense in a sense. And in another sense, it's not. And I think that if I were to think, and I'm just speaking for myself, right, that the only thing it took for me to get over an addiction of the severity that I had was telling my story, that would be semi-delusional. That was part of it. And there were a thousand other little things. Yeah, I've always really admired, and I came to admire it even more while I was writing my book, the present tense aspect of people in 12-step programs who acknowledge the ongoing potential or capacity to return to the state they were in. And so instead
Starting point is 00:33:18 of seeing it as a conquered story once told and then forgotten, it's an ongoing journey. conquered story once told and and then forgotten it's an ongoing journey and michael was described as having conquered his illness like it was a mountain and now he was on the other side of it of course hollywood has a you know habit of liking happy endings understandably but i found in writing my book that i wasn't just telling stories. I had to untell stories also because this idea, for example, that being smart was special. And when I looked into that, it wasn't just that we were from striving. My father was an immigrant refugee, really, you know, like the classic refugee story, especially Jewish refugees. You want to, you know, get ahead. Being smart is your ticket in. And in the meritocracy, that's true. But there was a very ugly period of time in the early 20th century where the mind was divorced from the soul.
Starting point is 00:34:12 You know, psyche means soul, and a psychologist does not study your soul. It studies your mind. And the measurable mind became something you could quantify to the point where in the early 20s, there was a Supreme Court decision sterilizing a woman because she fell below the level of acceptable intelligence. And Oliver Wendell Holmes famously said, three generations of imbeciles are enough. And the youngest generation was like nine years old and they sterilized her. And so when you only think of someone's worth in terms of their intellect, that is not the thing. It's funny, we began by talking about what it means to be theomorphic. For those who share this belief, as I do, that you're made in the image of God, that's the source of your equality and your worth. It's not how well you do on a test. And yet I think a lot of people felt
Starting point is 00:35:04 invested in seeing him as a brilliant because they thought if he didn't have that, he would have nothing. And I sometimes what my parents were very loving. But there's a reason I hid my dyslexia, even if I didn't know what it was called, and like to pretend that I'd read a lot more than I had. Because where would I fit in this society where all your heroes were people of intellect? And many of those people, by the way, like Nazi doctors, they were not our heroes. But intellect does not inoculate you. It's the culture you live in that applies knowledge that matters. And that's about morality. And I felt ashamed, in a sense, to have participated so zealously in something that had really stacked the deck against him in addition to all the other fantasies and good intentions. I'm Jason Alexander.
Starting point is 00:36:17 And I'm Peter Tilden. And together on the Really No Really podcast, our mission is to get the true answers to life's baffling questions like why they refuse to make the bathroom door go life's baffling questions like why they refuse to make the bathroom door go all the way to the floor. We got the answer. Will space junk block your cell signal? The astronaut who almost drowned during a spacewalk gives us the
Starting point is 00:36:33 answer. We talk with the scientist who figured out if your dog truly loves you and the one bringing back the woolly mammoth. Plus, does Tom Cruise really do his own stunts? His stuntman reveals the answer. And you never know who's going to drop by. Mr. Brian Cranston is with us tonight.
Starting point is 00:36:49 How are you, too? Hello, my friend. Wayne Knight about Jurassic Park. Wayne Knight, welcome to Really No Really, sir. Bless you all. Hello, Newman. And you never know when Howie Mandel might just stop by to talk about judging. Really? That's the opening?
Starting point is 00:37:02 Really No Really. Yeah, really. No really. Go to reallynoreally.com and register to win $500, a guest spot on our podcast, or a limited edition signed Jason bobblehead. It's called Really? No, Really? And you can find it on the iHeartRadio app on Apple Podcasts or wherever you get your podcasts. We were talking a little bit about this idea of forced institutionalization or forcing someone to take their meds. And I think that is a reaction to things like the forced sterilization of somebody who's not intelligent, the people who are forced into institutions.
Starting point is 00:37:41 And this is a really tricky area. forced into institutions. And this is a really tricky area. And I greatly appreciated in the book the nuance at which you take it on, because it is a slippery slope. Should I have been forced as a 25-year-old into treatment as a heroin addict? Maybe. And the court certainly encouraged. I was in plenty of legal trouble too. And there was a very strong encouragement that I go that direction, you know. And yet these questions come up again and again. And we talk about stigma. And you've got a line that I really loved. I want to just try and take a second here and find it. You said the problem with stigma wasn't only thinking that everyone with schizophrenia might end up like Michael in a violent crime, when only a very small percentage
Starting point is 00:38:26 of people do. The problem was an environment that saw even an inquiry into the possibility of violence among the untreated as stigmatizing. Say more about that. Well, one of the things that was interesting is that Michael had become, after the New York Times profile, which was so heroic, a real champion for many, many people. The woman who was head of NAMI, which is a wonderful organization, National Association. It's not for mental illnesses, for families of people with mental illness. I just always forget what the preposition is. But in any case, the woman who was head of it had a daughter who herself suffered from a psychotic disorder, and Michael was a real hero. When Michael killed Carrie, it was an earthquake for them.
Starting point is 00:39:07 And one of the things many of them began to say, and to say publicly, was that their initial approach had been to say that people with schizophrenia are just like everybody else. They are the person next door, which was interesting because Michael was the person next door for me. But they all actually bore literal scars as well as emotional scars because there had been times when their children were unmedicated and therefore dangerous in all kinds of ways, either to themselves or to others. And they began to wonder if perhaps it made more sense and would be more destigmatizing to acknowledge these as symptoms. They're not intrinsic personality traits. They're potential symptoms that therefore can be treated.
Starting point is 00:39:52 And in fact, people who are medicated are no more likely to be violent than anyone else in society. And the way I'm kind of think about it is like here was this extraordinary article in the Times three years later. He was on the cover of the New York Post under a single gigantic headline, psycho. And what could be more stigmatizing than that? And so sometimes acknowledging the potential for something is not a way of diffusing or denying it, but it does what actually a diagnosis did. People forget that before there was a diagnosis of severe mental illness, we'd call people possessed by the devil.
Starting point is 00:40:30 And they were locked in basements or beaten to get the devil out of them, or it was seen as a character flaw. And so there was a kind of enlightenment relief that this is a medical illness. It has a set of symptoms, same as other medical illnesses, and we don't treat it perfectly, but we do have things we can do. So it's not about you. There's a thing that you have unfortunately developed. We don't even know why, by the way. And we have, you know, crude but not ineffective methods of helping people. It's hard, of course, because it's the mind, and the mind is like nothing else. It's how we know the world.
Starting point is 00:41:05 And if you don't know the world because your mind is the afflicted portion of your body, or your brain is, then you won't believe you're ill. It is very tricky, but I often, when I read, when I started reading from my book or talking about it, I was always afraid, because I knew there'd be people who have children with psychotic disorders, and I was afraid that my book had told the worst case scenario. The dreaded thing had actually happened in this case. And how would they feel? Would they feel that I was tarnishing their families? And that has never happened. They have all identified with what might happen because they understand that when you are in a state that is totally detached from
Starting point is 00:41:41 reality, you are not responsible. And indeed, Michael was found not responsible by reason of insanity. And in fact, it's interesting to think even about the two wolves in this sense, because you want to feed the good wolf, not the bad wolf. But it used to be called the right-wrong test. You were not found guilty if you did not know the difference between what was right and what was wrong. And if you do not know, it is cruel to punish someone. But if you don't punish someone afterwards, it should affect how you think about the disorder untreated before as well. Not that these are simple. And by the way, I am not in any way recommending reconstituting asylums, state hospitals. Medication can be delivered in all kinds of ways. Supportive
Starting point is 00:42:25 housing, which is a kind of community mental health, which is housing where services are in the building for you. They're very expensive and they're hard to find, but they're very important. Those make an enormous difference. We failed people, but we're kind of maybe as psychiatry rebuilds itself, I'd like to think we will now fuse the psychiatric hospital and community care in a more natural, appropriate way. But it's so hard for all sorts of legal. Yeah, it is. In the book, when I read that section about some of the NAMI members sort of changing their mind to some degree around forced institutionalization, right? That's pretty telling, but I've been around recovery and mental illness situations long enough to know several families who have been
Starting point is 00:43:12 trying to make that decision, recognize that their loved one is schizophrenic, off their medication, and extremely dangerous to themselves and others. And it's not easy, necessarily, to get somebody admitted against their will to one of these places, nor should it be easy. I'm not indicating that it should be easy. I'm not actually recommending anything, because I think like you, it's a very difficult and thorny problem. But I think it's one that we have to be willing to talk about. And somewhere in the book also, it's a line from a woman who wrote a memoir about having schizophrenia. Ellen Sachs, is that correct? Yeah, it's a wonderful memoir. And one of the student advisors had gotten a maybe a fellow student released from psychiatric care. And they saw this as a legal victory that this person had gotten out.
Starting point is 00:44:10 And then that person went on to burn down their house, killing their parents and their seven-year-old brother. And she says, and I think this sums it up very well. For a bunch of idealistic law students, some lessons were harder to learn than others. And this one, that helping people isn't always a good thing. This is the line that I really loved. Or maybe that helping translates differently from case to face and must be cautiously scrutinized. And I think that's really the key here, right? It's not that Michael's situation, no one was cautiously scrutinizing whether what they were doing for him wasn't
Starting point is 00:44:45 necessarily the right thing. They thought it was. And again, everybody's intentions were good, but I love that line from her. And even when you do cautiously scrutinize, you still don't know, you know, that's the tragedy of these sorts of things. You know, I talked to a lot of parents whose children have addiction and they're like, well, should I kick him out? And I'm like, well, I don't know. I can't tell you that. Like that could be what turns them into recovery. It could be, I mean, we just don't know. Again, that's partially what drew me so into your book was the nuance at which it discusses things and how often people who are unwilling to admit nuance do real damage. Yeah. And the one thing I would want
Starting point is 00:45:26 people to recognize is like in New York City, when the mayor tried to broaden, he didn't even broaden it, broaden the interpretation of the statute, which allowed people to bring someone to the hospital if they were unhoused, too ill to care for themselves and so sick, they did not know they were sick. There was still like the headlines and all the major newspapers made it sound as if he was randomly rounding up all homeless people and hospitalizing them till forever. Whereas in fact, they were just going to be evaluated and then it would be a medical decision. But the alternative means that the freedom you think you're fighting for isn't how you might feel gathered up one day and like a Kafka character and just mysteriously brought to prison. You're allowing people who are
Starting point is 00:46:12 dying in slow motion all around you to die or to get arrested. And that's a different quality. I remember it was a real turning point for me. I read a memoir, a very honest memoir by a very idealistic psychologist. And in the 60s, he'd created a community mental health center in Baltimore's inner city, as they called it then. And what he said was that they had a few beds and they thought everybody in the community who was poor, marginalized, needed care because that all produced mental illness. The one group they wouldn't take were people released from mental hospitals because they just needed too much care. So what did the families do? The parents were just as poor, just as marginalized, just as victimized by racism or some other form of discrimination.
Starting point is 00:46:54 They called the cops. So this is what they consigned the sickest people that were the nominal reason for creating the center to. Your parents or your sister or your son or your father, your mother, your wife would call the police. If you were lucky, you wouldn't get shot because you were probably in a very florid state of psychosis. They'd bring you to prison, a jail cell where you'd sit for 24 hours, unmedicated in a state of abject terror. And it had never dawned on me how fully terror dominates the life
Starting point is 00:47:24 if someone doesn't know what's happening. And then the next day, perhaps you would be brought to a psychiatric hospital state of abject terror and it had never dawned on me how fully terror dominates the life of someone who doesn't know what's happening. And then the next day, perhaps you would be brought to a psychiatric hospital where perhaps they would take you, though more likely if they even took you, they might release you a day or two later. Because at that point, being violent was legally turned into the only criterion for hospitalization as if that were the only symptom, and it isn't even a symptom. And so people wonder why there's an association between mental illness and violence. Well, you can't get care simply for being sick, and it's one of the most intractable illnesses. You can only get care if you're in immediate danger to yourself or others. As one psychiatrist
Starting point is 00:48:00 said to me, if you have a noose around your neck or a knife in your hand, and often by then, needless to say, that does not mean it is a simple problem. Framing it, again, what I said, I love so much about the parable, this parable in particular, and parables in general, is that it's holding two contrary things together. They live side by side. Framing that dilemma isn't the same as solving it. Stories don't have to solve a problem. Just articulating aspects, maybe contradictory aspects of it. And I have been very moved by the number of people who are wrestling with different aspects of this, who have felt found inside of it, even though I don't give any answers. It's very humbling, actually, because I always feel mildly ashamed.
Starting point is 00:48:40 That you don't have answers? That I don't have answers. And that's something that I was also began with a reckoning with something so personal for me. I mean, I'm moved that for me, it was always this guy who was so extraordinary, lived on my street. Finding out in a way he lives on everybody's street was part of the process of writing the book. But you want to do more. I understand the impulse, by the way, to just want to fix. My wife is a hospital chaplain and she's been wonderful for telling me that sitting in the presence of someone who has pain, not trying to solve it, merely allowing that pain to be expressed is itself a service. And I kind of approached a
Starting point is 00:49:17 lot of my interviewing that way, actually, and it made a big difference. Yeah. Yeah. I mean, there are things that unfortunately can't be fixed. What's the phrase? They can only be carried or something along those lines. They can't be fixed, but they can be carried. That's a good way of putting it. I've never heard that. All right.
Starting point is 00:49:34 I'm going to completely change directions on us here. You take boxing lessons. Yeah, I do. And you know what's funny? My boxing teacher told me the wolf parable years ago. Oh, really? Yeah. She also goes by the name the Hawaiian mongoose, which is a sweet name. Isn't it? That's her fighting name. Eileen Olszewski. She's a terrific trainer, by the way.
Starting point is 00:49:54 So how long have you been taking boxing lessons? I don't know, maybe 15 years. Oh, you must be actually decent. Do you spar? I used to, but not in a meaningful way. Like, especially when I was old, even when I started and I didn't go Mickey Rourke where I was like, it's okay that I'm just going to be fighting a bunch of people. It's not like that at all. It really started because I was at a crunch and I, they had a speed bag and I just somehow, occasionally, you know, you're going to be able to do something and you want to do it. So I was hitting the speed bag and actually,
Starting point is 00:50:23 I think it was Miyoko or maybe her husband, Matthew, who's her trainer and a fighter himself, came over and showed me how to do it. And then I just loved it. And that led to hand wraps and that led to gloves and that led to boxing and that led to a ring. And again, if someone had told me when I was little how satisfying and important it was to hit something, I think I would have been, it would have been good for me in all kinds of ways. When they would put me in the ring with someone, it was somebody who was really training to fight and wasn't allowed to hit me back. And I got to throw at them, which didn't mean I ever connected. And in fact, initially, part of my training was that it made me nauseous to even imagine that I would hit them. And then one day, I was hitting this double end bag, and I was going to be sparring that day.
Starting point is 00:51:05 She said, you want to hit him now, don't you? And I was like, well, maybe just a little. Just because they kept saying to me, you're not doing him a favor. You're not going to knock him out and you're probably not even going to hit him. But in any case, it's a martial art. And so if you don't get hit in the head a lot, when you watch these lighter fighters, defense turns into offense, the whole sense of having a body. And, you know, if you've read my book, you're like having a body had been left out of
Starting point is 00:51:30 the recipe somehow. And not only is that a sorrowful loss, but it's also not good for your mental health because your mood is an aspect of your body. So all of it was part of just a, it was just a kind of joyful thing. And I really loved my trainer and she's a wonderful person. The fact that she told me that parable was precisely because they understood that getting angry is not how you fight. It's not a good attribute because then you lose your control actually, you know? Yeah. So yes, yes, I confess, you know, my daughter was young enough when I started.
Starting point is 00:52:01 I think there was a very brief time where she thought it's what I did. And it was hard for me to have to tell her, you know, she would tell people who would come over, my dad's a boxer. And they'd look at me like, really? You know, and I'd be like, no. Did you take on a fighting name? Do you have a fighting name like Hawaiian mongoose? No, I did not. Although because I wrote a book about birdwatching, they would sometimes call me bad bird, which I'm embarrassed to confess, but here I have. Mocking, loving, but you know, there it is. Maybe I'll read your book on birdwatching and have you back on because I am a fan of the birds myself, for sure. Birds are great. Yeah. All right. Well, I think we're going to wrap
Starting point is 00:52:40 up there. Thank you so much for coming on. Thank you for writing a really great book. It's extraordinarily well written. You're a great writer and wrestling with these difficult questions. Thank you. Thank you so much monthly donation to support the One You Feed podcast. When you join our membership community with this monthly pledge, you get lots of exclusive members-only benefits. It's our way of saying thank you for your support. Now, we are so grateful for the members of our community. We wouldn't be able to do what we do without their support, and we don't take a single dollar for granted. To learn more, make a donation at any level, and become a member of the One You Feed
Starting point is 00:53:39 community, go to oneyoufeed.net slash join. The One You Feed podcast would like to sincerely thank our sponsors for supporting the show. I'm Jason Alexander. And I'm Peter Tilden. And together, our mission on the Really Know Really podcast is to get the true answers to life's baffling questions like why the bathroom door doesn't go all the way to the floor, what's in the museum of failure, and does your dog truly love you? We have the answer. Go to reallynoreally.com and register to win $500, a guest spot on our podcast, or a limited edition signed
Starting point is 00:54:12 Jason bobblehead. The Really No Really podcast. Follow us on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

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