Soteria: Through Madness to Deliverance. Loren Mosher, MD

Abstract

Soteria: Through Madness to Deliverance. Loren Mosher, MD, Voyce Hendrix, LCSW, with Deborah C. Fort, PhD. Philadelphia: Xlibris, 2004, 340 pp., $22.99 (paperback). The word soteria is Greek and means deliverance. The book Soteria describes the 12-year life of the Soteria Project, in which, from 1971 through 1983, groups of nonprofessionals, poorly paid workers, and volunteers maintained two small residences, Soteria House and Emanon ("no name" backward) in the Bay Area of California for mostly young adults who had been diagnosed with schizophrenia. The book describes the deliverance of many of these troubled young people through a program that refused to damn them with moral labels in the guise of medical diagnoses; treated them with the respect they deserved and needed as human beings; avoided all coercion (except in rare cases of violence); and avoided the use of toxic drugs, euphemistically called medicines, unless requested by the residents. But Soteria does more than describe a program that deserves to be the model for offering help to suffering individuals who disturb their families, society, and themselves with their unreflectively chosen solutions to their life's problems. It also provides a deliverance of a kind for those of us in the so-called mental health field who have grown hopeless and cynical in these bleak times. In these times, one is treated as mad if one questions the validity of the diagnoses crowding the Diagnostic and Statistical Manual of Mental Disorders; psychiatrists in the pay of large pharmaceutical corporations proclaim that it is unethical even to contemplate treating those diagnosed as schizophrenic with other means than drugs; and a majority of U.S. states have laws permitting the incarceration and forced drugging of individuals against their will. Soteria reminds us that other scientific and moral visions have existed and can exist again. The book is organized into a number of chapters. The introduction is the longest chapter and describes the author's assumptions concerning the nature of so-called schizophrenia and other psychotic states of being, and the philosophy of the program designed to help the residents (the word "patient" is never used) to graduate (that is, to reach a point in their development as human beings where they can live more loving, productive, creative, and independent lives). We learn that all those working at Soteria embraced the notion that recovery from psychosis was not only possible but probable and to be expected. . . . rather than seeing psychosis as an unfathomable mystery Soteria staff treated it as an understandable coping mechanism comparable in some ways to shell shock. . . . two aspects of family life are consistently associated with what's called "schizophrenia": parent's communication deviance (inability to focus and be clear) and parents' hostility to their children. (p. 23) "Soteria staff believed that almost no one was too crazy to talk to. . . . Loren [Mosher] comments, 'If you treat people with dignity and respect and want to understand what's going on, want to get yourself inside their shoes, you can do it'" (p. 33). These words provide the reader with the basic philosophy of Soteria and point the way toward understanding the treatment provided. The staff who worked at Soteria were generally carefully trained and supervised nonprofessionals. They included students from various local universities and, most importantly and interestingly, graduates from the program itself: Loren believed that the inexperienced and psychologically unsophisticated can adopt useful interpersonal-phenomenological stances vis-a`-vis psychosis more easily than highly trained MDs or PhDs because the former work from no theory of "schizophrenia"-psychodynamic, organic, or both. Because they are unburdened by preconceived theories, nonprofessionals are free to be themselves, to follow their untutored responses, and to be spontaneous with psychotic individuals. …