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Susanne Paola Antonetta, "The Devil's Castle: Nazi Eugenics, Euthanasia, and How Psychiatry's Troubled History Reverberates Today" (Catapult, 2025)
01:02:11
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- [00:01]
A
Welcome to the New Books Network. In this episode, I'm joined by Suzanne Paola Antoneta, an acclaimed American author, poet and essayist whose work sits at the intersection of science, social justice, spirituality, and deeply personal experience. Her books include A Mind Apart, Make Me a Mother, Body Toxic, and four collections of poetry. Today we're talking about her latest and perhaps most urgent book, the Devil's Eugenics, Nazi Euthanasia, and How Psychiatry's Troubled History Hurts Us. Now. Her writing blends history, memoir, neuroscience, and her own lived experience with psychosis as she explores the legacy of psychiatry, the meaning of consciousness, and the urgent need for a more compassionate approach to mental health. This is a haunting, thought provoking, and ultimately hopeful book that challenges the way we think about madness, neurodiversity, and what it truly means to care for the human mind. Welcome, listeners. I'm Elizabeth Cronin, a host for the New Books Network. And today I am talking with Suzanne and Tonetta about her book, the Devil's Castle. Thank you for being here today. I'm excited to talk with you.
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B
Thank you so much for having me, Elizabeth.
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A
So usually where we start is by trying to get a feel from someone about why they came to write this particular book. I don't know if that's a good entry for you.
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B
Sure, it's a good entry, but it's a winding path. So I think I'll. I'll try to give you a little bit of a nutshell sense of it. I actually started researching Paul Schreber, who was a German judge. He was hospitalized in the late 1800s, and he litigated his own release. He fired his lawyers because they couldn't get him out, and he litigated his own release. And actually because he was doing it all from an institution, there are tons of documents that he filed about his case. But as I researched that, I learned that his institution had, a few decades after his death, become a death center for the Nazi killing of the neuropsychiatric population, which began several years before the Holocaust. So I started out telling those two stories, but sort of inevitably, that just led me to how much German psychiatry has influenced the psychiatric world we live in today. So I'd say maybe half the book is history, but at least half is not. And a lot of it is my own story as a psychiatric patient. So all those things, it's a book that goes a lot of places.
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A
So what brought you to want to start doing research on him, on Shraver?
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B
Because I just love his court case because the man was. And I'M completely speaking here as a member of our culture. Mad as a hatter. He had visions of God. He had visions of what the universe looked like from the inside. He just had incredible visions that we would consider psychotic visions. But he defended himself on the grounds that these were valid spiritual experiences. And he faced down his asylum director in court, and the judges actually all agreed with him. They said, you are brilliant. You are amazing. You're a good man. And they just kind of mocked the doctor. So it was just. And Schraeber's filings actually changed German laws about insanity and coercion and being able to hold people without permission, without their permission. So his story is amazing, but it ended up being kind of a small piece of the whole thread. It's like neurodiversity versus cultures that just want this incredibly enforced normality, which I think is something you and I both have experienced in our own lives.
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A
Absolutely. And I think that's what's so interesting about, you know, the book. You. You share a bunch of different points of view and experiences of what it's like to be on the receiving end of psychiatric care, and that his particular case is really interesting because, as you said, here he is somebody who you would say is, you know, crazy, and yet he's so coherent and he was so capable and articulate. So it's really interesting. It raises that question about who's to say that somebody who is a little crazy or someone that's having a psychotic or hearing voices that they don't. They can't do important work.
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B
Absolutely. I mean, he saw. He heard voices. He saw, you know, little men. He had a lot of what we would consider delusional visions. But I want to stress, he saw the coming of National Socialism. I think, in a way, very few people did. He had visions of his asylum becoming a death chamber. Also, he transitioned to female while he was institutionalized. So some of the court back and forth between him and his Dr. Weber was things like the doctor saying, you know, one of his delusions is thinking that women have sexual responses in their breasts. And we all know that's ridiculous. Of course they don't. And then Schrager would come in and say, oh, yes, they do. So, you know, he's so much more on target than everybody around him, and that's what the judges saw in him. Like, however he's getting there, this is a brilliant man who's had real insights, and we still need that. We still need somebody to get up there and say, you know, what? A lot of people don't need medication. They need to be listened to.
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A
Right, right. Well, so that brings up the other person that you talk about in the book to Dorothea Buck and. Yeah, and she. Her experience and her premonition about Hitler and the war too. Like there's really do need to listen.
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B
Absolutely. She saw the war in 19, 1936. She had several visions, and some of them, we would say, are simply out of reality, out of consensus thought is how I ended up putting it, because I think there's a reality sometimes to the non consensus thought. But she saw the sun rising in a way that it doesn't rise. She saw a star that I think we would say doesn't exist. But she also saw that Hitler's war was going to happen and it was going to be monstrous. That was her word. And she contacted all the adults in her life, including her choir director, and said, we all need to talk to Hitler. We can't let him do this. He's going to destroy Germany. He's going to destroy the world. And everyone said, this is a symptom. She's crazy. She got taken to a psychiatrist. She got treated. She was seeing something that everybody else was missing, even though I think it was right in front of them. And I think that many times. And I work with a lot of. I'm neurodiverse myself, but I work with cultural autism studies at Yale, several thousand people on the spectrum. I know a lot of neurodiverse people, and I think that in some ways we often have fewer filters and may express ourselves in a way that's different to sort of neurotypical expression, but is still seeing something that's very much there that other people might be missing.
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A
Mm. It's interesting because, you know, we think we. We've learned so much about the brain, especially with, you know, functioning imaging and all that, but there's so much we still don't know. And when you say maybe neurodiverse people don't have as many filters, I mean, it makes me think about, like, highly sensitive people and maybe they have more mirror neurons and things like that. Like, we still just don't understand. And to your point, it's interesting that people can see things differently. I mean, we all see things differently, Right? I mean, when you say consensus reality, maybe you can say something about what you mean by that.
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B
Absolutely. And one of the things I do get into in the book is contemporary neuroscience, because I think neuroscience has a lot of the answers to a lot of psychiatry's problems. One of the things that I go over in the book is a bet between Christophe Koch, a neuroscientist, and David Chalmers, the philosopher of consciousness, and how in the 90s, Koch bet him that by this time, by 2020, I think it was 2023 was the. The date when the bet ended, that we would know for sure how consciousness happens, because we just discovered functional FMRIs, functional MRIs. We could see things happening in the brain. And, yeah, we'll see that it starts here and it moves there, and it's this kind of electrical impulse, and we don't have any of that. We haven't found anything. Finally, publicly, at a conference, Coke gave up the bet, said I lost, and gave Chalmers a lot of expensive wine, which was the cold story. But fundamentally, I think it was 2019. The American Psychiatric association finally announced, we are not going to be able to use scans. They don't tell us anything about psychiatric problems. They. The more we know, the less we know when it comes to consciousness. And I think that neuroscience responds to that information with, this is wondrous. This is miraculous. Let's just sit in wonder of what we all can do. And psychiatry is more like, let's look at the DSM and find a number and give this a name and drug you. Not that vocation's always bad, but it's overused.
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A
Overused, yes. And maybe you could speak a little bit to that about the sort of biological basis of psychiatry and the history there.
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B
Sure. Because I think it's extremely important and it's extremely misunderstood or not understood. There's a German doctor named Emil Kraepelin who came along in around the late 1800s, Schreiber's time, and basically said, psychology is mushy. We want this to be a real science. We want it to be a real medicine. And everything that happens to somebody, whether it's a lost job or a lost love, it's because of something happening in their brain. It's not life experience. It's not parenting. It's not the sex drive. You know, he was kind of facing off with Freud. It's something happening in the brain. Psychiatry needs to be biological. And so we created all these disease categories and basically also trained a lot of the Nazi doctors. In fact, the worst of the worst were Kraepelin students. He was not himself a Nazi. He died in the 20s. So in 19. In the 1970s in the United States, a group of psychiatrists, you know, coming out of a very psychological period where people did examine their families, their mothers, all these things, for clues to why they were depressed or psychotic, basically called themselves the Neo Kraepelinians. They took Kraepelin as their guiding light and went back to the idea that it's biological. It's things happening in your brain, it's brain chemistry. You still see that phrase everywhere. It's neurotransmitters. Well, we now know that's not true. We know serotonin and depression. If there's a relationship, we can't prove it. There's no. You can study things like how many serotonin metabolites are in the body to see whether it's low or high. There's no relationship that we can find. Right. Which does not mean the medication doesn't work. That's another question. We often don't know why medication does or doesn't work. But that has been an absolute disaster. You know, the Neo Kraepelinians said things like, let's get rid of the hour long appointment. It can be 15 minutes. It can't. They were, you know, we can maybe even say it was a heroic effort. They thought they were reducing stigma. They thought they were helping. There were reasons to think these things could work. But as often happens in medicine, they. They didn't. We mostly are a much worse off population than we were in the 70s. So one of my arguments is, let's get Kraepelin out of here. The man was creating his biological psychiatry, as he put it, to clean up the population. It's a system designed not to help patients so much as to help the state to get unworthy people out and get them away from breeding. The sterilization laws in Germany, passed in 1933, was dedicated to Kraepelin by two of his students who wrote the laws. So why do we have this man in our headspace? Literally, it's time to get that out. It's time to look at biological psychiatry and admit that much of it hasn't worked. And let's look at what has worked, because we actually have lots of good models from the past and the present.
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A
Right. And you bring that up in the book too. You share some even. Like Dorothea Buck, her model, the trialogue. Is that what she called it? Maybe say something about that because.
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B
Sure. And I want to say, because I know this is something that's important to you and it's important to me that what Buck talked about and even what Schreber talked about, because Schraber left us a book, we know what he thought about was mindfulness. Yeah, they didn't use that word. It just wasn't in, you know, in currency. But what Trilog did was use clinicians, family members, and other people who'd had similar experiences coming together in large groups to talk and sharing peer support and creating systems like sensory. Some people responded really well to sensory stuff. I mean, one woman in Buck's letters wrote her that mint oil could turn her around. Mint oil and massage and just being aware of her body. Some people would create medication contracts, like, if I'm acting in this way, you can give me this drug for two weeks and then we reassess. So they felt comfortable going into care knowing it wasn't going to be whatever the doctor decided for the rest of their lives. But a lot of it was just peer support, just sharing what worked for them and died. Mystifying what happens in the mind, right? Like 17 to 20% of people, all people hear voices at some point in their lives. Sigmund Freud heard voices. It's one of those things that is quite normal. But if you go to a doctor and you say, hey, I'm hearing voices, and they reach for the dsm, which is the book they use to diagnose, oh, it sounds like schizoaffective disorder, we're going to put you on this drug. That's a very different experience than if the doctor says, do you know what, one out of every five people you meet has had the same experience. So let's break it down. Are they scary? Are they frightening you? Is it just frightening because you feel like you're hearing them from somewhere else? There's actually brain function reasons that voices can sound that way. So she had people who heard voices sometimes just walk around with a tape recorder. So they'd come in and say, you know what? That voice that tells me I'm evil or whatever it is they're hearing has been talking all day long. Okay, playback your tape recorder. Of course there's nothing on it.
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Yeah.
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B
And then they talk about, why then do you think you're hearing this voice? It's something you're saying to yourself, what can you learn from that? That was the big question in trial. What her. Buck's book, which is available as a free download at Punctum Books, is called on the Trail of the Morning Star. Psychosis is self discovery. So that was where they started with everything. What can we learn from this experience? What is it teaching you? What is it telling you you need to do in your own life? And it was very successful. And a man in the US, Lauren Mosher in the 1980s, did a, an experiment that started out with the name Soteria, where he didn't medicate people in psychosis, they did. And he made it a double. He was a, you know, the head of one of the heads of the ni, the National Institutes for Mental Health. He was a big, big figure and he set it up as a double blind. He compared them with people hospitalized and treated with drugs. They did better. So we know what works. We know what works.
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Yeah.
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We have to say we want the resources, we want the attention to this.
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And I think what's interesting too is that it could. Doesn't even have to be that complicated. I mean it could be. There could be an approach where family members are just there to support somebody with this having a psychotic experience. Right. As long as you know it. It's akin to people doing a psychedelic journey. Right. And they just need somebody there to make sure that they're going to be safe, but that it then becomes an opportunity for them to be in an altered state. Maybe they hear voices because they're under the influence of a substance, whether mushrooms or whatever. But I think there is a little bit of a shift towards starting to understand that we could actually lean into some of these voices or we could start to be curious. What does it mean? What are you learning about yourself? Or what are you learning about something you're perceiving in these voices? Yeah.
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B
And depression, I think, and anxiety. Certainly people feel outsized feelings a lot of the time, but there's rarely nothing there. So a trialog would go to those problems as well with what is there. We're going to talk this through and we're going to see what works for you. And that could be a. There's a really wide umbrella of things that work with depression and that includes exercise. They're double blind studies where it works as well as antidepressants, which don't work particularly well is therapy. I mean there's just so many different things.
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Even, even it's. So if the whole medical profession doesn't really emphasize enough what we eat, what you put into your body, a hundred
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percent, that can make a huge difference with depression and anxiety. Absolutely. So it just takes time. And the thing is that you know that really what I think. Negative neo creepelinian. Let's make it 15 minutes, not an hour. What that does is it creates a 15 minutes. That's 15 minutes for the rest of your life. You're not saving time, you're not saving resources. You are offloading a lot to the drug companies in the way of profits. Huge problem, of course, but As a society, are we benefiting from that? Are we saving anything? No, we're not. We're creating homeless populations. We're creating people who can't work where, you know, look at where we are. And I think that another thing that you see, if, like me, you. You research psychiatric history over time, you see a lot of bad things happening to women and to minorities, but women more across the board, even in Germany. And it broke my heart because I researched the German euthanasia programs and the, you know, somewhere between 80 to 100,000 Germans who died for having neuropsychiatric conditions. And a lot of them were women. A lot of them were depressed women. Several cases that I found personally were women who'd been abused. You know, I mean, they're actually being beaten at home and then taken to an institution for depression. That's the story that you see again and again. You see it in the US with lobotomizing. It was mostly women, and it was often women brought in by husbands who were abusing them. So. And. And blacks in the black people in the United States have a very troubled history with psychiatry as well. So I think that we. If you're holistic right off the bat, which people are now doing, like in Northern Italy, they've had a lot of success, then you're going to get just a much more robust turnaround in people. And like I said, I think we know the things that we need to do, but somehow the system needs to change. And I do think it is starting to change. I think there's getting to be way more honest reporting on medication withdrawal, for example.
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A
Yeah. And I think that the influence of Eastern cultures is starting to shape a lot of research and. And in general, opinions about things. People are becoming a little bit more open. I mean, just. Even the. The whole acceptance of yoga now, which I remember when I was in, you know, grade school, yoga and yogurt were both kind of strange things when I was in elementary school. And now they're like mainstays, you know, and.
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Absolutely. Yeah.
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Yeah.
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B
And like I said, I think that idea of mindfulness, if you sort of, you know, look at it broadly, being full with your mind, being sitting with your mind, learning to understand it and accept it. I mean, my mind does things that most people's don't. I do hear things at times, and I have learned to. And Dorothea Bupp is actually my best doctor because I went so far down on medication after learning just from reading her book and her letters, how she managed things. You try to understand where it's coming from you try to understand that your wondrous consciousness, which neuroscience will tell you is in some sense hallucinating the world around you for everybody.
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A
We're all hallucinating? Yes. I mean, we're all walking around in a trance.
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B
That Anil Seth is a brilliant neuroscientist in London and in England. And he and I actually kind of became buds. I interviewed him a few times. And his, his research on how much we are always generating the world around us through our inner world. You know, a dance of prediction and correction, he calls it. Rather than directly engaging with something called reality, which he has said many, many times, it's a controlled hallucination. It's how many people are feeling and seeing the same thing. The fact that they're not could just mean they're being good Germans.
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A
Exactly, exactly. And actually to kind of go back a little bit to the like the hearing voices kind of thing, you know, I think it's. I think it's funny that, you know, so many of us don't think we're hearing voices because when you become, if you meditate on a regular basis, what you can do is you can start to be aware of the voices in your head. You don't hear them, but there are voices. There are multiple messages that you're getting. Do it, don't do it. You know, she didn't do it. You know, the comparing, the judging, the assessing, the planning, the ruminating over the past. I mean, those are all voices. I mean, absolutely. I mean, it might not be auditory, but I think there's something to be said about recognizing them. And that's part of becoming more self aware is recognizing that we have this idea that there's a person in charge or something, that there is a voice. But it's all these conflicting messages that we're giving to ourselves that create our reality and skew our reality.
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B
Right. And understanding that process is defanging the scarier stuff, you know, and that is something that Schreber did for himself and Buck, you know, not just did for herself, but taught others to do. And you know, again, it's. It's been practiced again and again. I mean, even Philippe Pinel, who was lived in the late 1700s, he lived into the 1800s, but in the late 1700s he started this movement called the Moral Treatment in France. And these terrible asylums where people were literally chained and flogged, he released at one point.
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I think you talk about, they would bring people to torrid and come in, look at these people. That's just awful.
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B
And even poke them to get them to sort of respond.
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It's like going to the zoo or something.
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It was absolutely treated as the zoo. It was a Sunday afternoon entertainment. Even in Victorian England, they would go to the Bedlam Hospital. Yeah, it was quite terrible what they lived with. But Pinel came in and cured them. And when people asked him, you know, what did you do? He said, I understood their hopes and dreams. I restored that to them. That's what he said he did. And he said it was far more important to understand the patient than to have sort of a disease that, you know, a disease that you understood that the patient was always central because their story is the thing that will tell you what you need to do next. So, I mean, this. This guy said this in 17. In the 1790s. Why are we still. We still aren't listening to him. We're not even listening to Hippocrates who lived in 300 B.C. and said, it's much more important to know your patient than to know an illness.
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A
So do you have ideas about that, about why that is?
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B
It is because the idea of biological psychiatry that, you know, as I said, we resurrected from Kraepelin and kind of paraded out in the 70s and 80s and embedded in our DSM, it just works really well for drug companies, it works well for doctors. You know, who wants to pay to get $200 for an hour when you can get it for 10 minutes? So it has worked well for everybody except the patients. I mean, we see now we're in this epidemic of unhappiness and of diagnoses. So if it were cancer, right, and 1 in 5 or 1 in 4 people, and the number fluctuates, was being treated for cancer, but more people were dying of cancer, we would kind of know, hey, we need to change this treatment. It's not working. It works for a percentage of people, but it's not working for many people. But because it's the mind, we've just kind of been in this rut, really, since the year 2000, of seeing things get worse and making excuses. It's social media, it's Covid, it's fomo, it's celebrity culture. All those things can contribute, but what we're doing for many people doesn't work. And there are things that can work and we can even practice those things. That, for me, is the takeaway. Mindfulness is super helpful. But when you're practicing mindfulness and doing all this good stuff on your own and you're seeing a psychiatrist who still just, okay, you have that. Will you get this drug? You can't fix that part of the system yourself.
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A
No, no. This is getting into the, the political. And I think what you're referencing now is capitalism.
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B
Sure.
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How do you, how do you fight like the, having the money, Money is power. And when you've got big drugs companies with the ability to influence, you know, politics, it's, it's a tough road.
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B
It's a tough road and it requires, you know, lots of people to start doing things differently and to say, I want, I want a caregiver who's doing things differently. I want a caregiver who understands the psychology of this experience and not just the pharmaceuticals of this experience. And I understand it's, you know, it's, it's a tough road and I don't know that I'll survive to see things get better. But the fact is that, you know, if you went back a couple decades and said, are we ever going to get out of this awful thing that's happening with opiate drugs? People would say, no, there's too much money there. And that did happen. We did get out of it. We, we, you know, we got out of smoking being what you did thing in the morning and all day long thinking it was totally fine. We can change. It just really takes enough people deciding to. And I think there are a lot of good people. Like Laura Delano has done a lot of great work with her Inner Compass initiative. And I'm seeing way, way more media coverage of the problems with psych meds these days that used to just never happen. Now it's kind of all over the place. So I think that if you start, you know, just look, you know, putting some sunshine on all of that, it's going to cause some gradual changes. I mean. No, go, go ahead.
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A
I was just gonna say that's where social media sometimes can help now because people can give their personal accounts and be it and put more, shine more light on the numbers of people that are not having good experiences.
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B
Right. And I think the way things usually happen in the US and we can look at like Finland, which requires doctors to offer non pharmaceutical help and that's required. I think that there'll be maybe a state or two, you know, like Massachusetts kind of started with decent health care that says, well, we're going to make this the law and we're going to see what happens. And when it, when it's popular, then it will spread, which is what happened here with healthcare. I mean, I didn't think I'D see even what we got with Obamacare in my life.
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A
Right, right. Yeah, I think that's true. I think some of this, though, goes to the fear that's involved both for people that are experiencing some sort of mental difference or difficulty, their fear, and then the fear, it evokes some people who are trying to help them or don't know how to help them. And I think that's a big component of it.
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B
It's a huge component of it. And I've dealt with family members in psychiatric crisis, and you just do what you have to do at those moments. And with myself as well, you know, I've had moments where it was just overwhelming and I just went on a lot of meds and I wish I had had what Buck, you know, Buck's people in the 20th century, long before us, had. If I had had a medication contract, that would have made my life so much better.
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A
Yeah.
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B
So I don't, I don't critique anyone for what they feel they need to do, but I would say that as a long term strategy, you need to be looking at life, life experiences, how the situation developed and, you know, what the situation is telling you, which is what Buck was so. Was so important to her.
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A
Yeah. And I know that you write a column for Psychology Today, so I feel like I've read something that you wrote in one of those pieces about. I forget what it is about. I forgot what it was about. But in general, this idea that
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B
if
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A
we could get through just the fear and the discomfort, and I think this is where mindfulness or meditation practices, grounding skills can help. Because if you can stay with what's painful and difficult, I think what you were writing about something, you were embracing that idea of like leaning into what's difficult and just not so quickly trying to run away from or get rid of the symptom, staying with the symptom or with the fear, whatever's showing up long enough to understand what maybe you could be learning in that moment.
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B
Absolutely. And I think that's where with Buck, having peers involved was really important. And she actually started that trial log method based on what she and a group of women patients had done in an institution that was just a, you know, it's just a warehouse. They were completely ignored. They're all spitting out their drugs. They all figured out how to do that. And so they had nothing to do. And they would just kind of pull chairs together and talk all day long. And what they would find was somebody, you know, a young woman, maybe it was her first psychotic Episode or depressive episode would start talking about what she had experienced. And then these older women would say, yes, I had that. I saw that, I heard that, you know, or I felt that about myself. It lasted this amount of time. Because depression, one of the things about depression that we've stopped telling people is that it almost always wears itself out. Lifelong depression, absent meds or absent someone telling you that can happen is very rare. I mean, we have records going back centuries. It usually has a few months run, and then somehow gradually, unless there is a really terrible life event going on, can resolve. So they would just hear, yeah, I heard a voice saying that, yes. I used to hear somebody laugh at me when I felt. I mean, just a lot of it was just that getting rid of what this wonderful British writer calls the madness of fearing madness.
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A
Right.
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B
Because I used to get that. You know, I taught college. I got that. I taught nonfiction. So you really learn a lot about people when you read their nonfiction. And I had so many students say to me, this happened to me, and my brain is sick, and I'm, you know, essentially telling me they were doomed. And they would actually talk about their brain like it wasn't even part of them. Like, my brain can't do that. My brain will never be able to do that. And it was all like they were channeling what they heard from doctors. But I would always think, my gosh, if you could just get in there and change that script. Yes, I experienced that too. I thought that about myself. And this is what happened. And it could be so different. Like I said, it could be. Women would. Because I know in the trialogue seminars, people would come in and they would recommend things like massage. This one woman talked about mint oil, meet various kinds of music, limited amounts of medication. Certainly they would all talk about therapy and how therapy had worked in helping them understand. But there was this. That mentoring just defanged the experience because you're looking at someone much older than you says, yeah, I'm here. I am. I've lived a lot. I have a job, I have kids. I had that experience as well. And it was just life changing. So that's super important.
- [36:42]
A
Yeah, it's making me associate to what in, you know, as a therapist, I would call normalizing. You know, and when. A lot of times when someone comes in for therapy, they have all this embarrassment or they're feeling shame around something. And when. When they hear like, oh, I hear that all the time, it. Right there. There's just that relief. You know, a lot of people think it's this deep, dark secret that they, you know. You know, sometimes they hate their child, for example. Love my child and. Oh, no. But sometimes I might. I secretly. I just hate them, you know, and it's like you hate something they're doing, and that's totally understandable. Everybody at times hates the behavior of a child or a partner or parent, whatever, and that's just normalizing because again, those voices that we all have in our head are telling us that we shouldn't be thinking certain things and we shouldn't be doing certain things. And. And there's real value in being able to get that out there. Just have somebody witness, somebody willing to hear and witness that. This is my experience and tell you that's okay. You know, it's not. There's nothing wrong with you. Nothing wrong with your brain, like this portion.
- [37:58]
B
Correct. And somebody to say, this will end. Because psychosis is the same if you don't, you know, if. Absent other factors. Because I think antipsychotics actually can prolong psychosis because you can't get off them. And you have to take more and more. Absent that, psychosis usually just resolves itself in a couple of months. And that can be a long, you know, long waiting period for everybody involved. And you might need. If somebody is dangerous to themselves, to others, you. You need to take action. Of course. Course. But I think in a lot of cases, just hearing that for people was pretty transformative. Oh, okay. I. I have to do this till April. I can do this till April.
- [38:43]
A
Right. And I think somewhere else. You were talking about this idea that maybe if we redid the dsm and for people who don't know what it is, it's a diagnostic statistical manual for treatment for mental health. And the medical field uses it, and so the field of psychology does as well. But it's this big book where everything you could possibly have is listed out there with numbers and all these. All these, you know, nuances of how it can present and how long and all this kind of stuff. But as I'm listening to you, I'm thinking, wouldn't it be cool if you got people together and they said. We had a manual that said, oh, the first time you have a psychotic experience, it tends to last this long, you know, but, you know, following episodes are sometimes shorter or longer or what? I mean, what about if we just had a manual that said what people experience instead of what's wrong?
- [39:42]
B
Absolutely. Just what's on the continuum of human experience? I think that's a brilliant idea. I mean, the DSM to me has become such a, such a negative force that I think it just needs to go. It's very corrupt. It's kind. I have one in my office, I know it well, but it's kind of ridiculous. I mean, one of the categories is caffeine induced sleep disorder.
- [40:07]
A
Who hasn't experienced that? We've all had that.
- [40:10]
B
Well, even bipolar disorder, which I spent a lot of time in that section because that's me. There's like seven things. They have us choose your own adventure. So there's exactly seven things in any three of them, except that it's seven things, not all of which are negative. So you could actually be diagnosed and not even have a problem. You could just have lots of ideas and feel kind of lots of enthusiasm and be sleeping a little less, which is like everybody, you know, getting ready to graduate from high school or college or start. You know, I don't need to tell you it's a very, it's a bad document. It's got 660 categories. I mean, it's ridiculous. But yes, I wish, you know, a DSM for how normal people function within this very large bandwidth of difference would be a beautiful thing. Right.
- [41:08]
A
I remember when my children were little and I was trying to stay current with like what was appropriate to expectations for them. There was a series of books and I loved it because it was just like your one year old. It was a skinny little book just about being one, your two year old, your three year old. It was, you know, like that. And I loved it because it said, it used to tell you, here's the range of things that you would see. It was written by, by people that observed rather than people that were looking at the research on the testing that they'd done and where people, you know, it was just that and I, it was always such a relief, like, oh, it's okay. It was like you said, there's just this range of what
- [41:49]
B
we expect, right?
- [41:51]
A
Not what we expect to say, but what we actually see.
- [41:56]
B
Right. And one of the things I talk about in the book is how I think we're at a historical moment where our bandwidth for normal is so narrow. I mean, even looking back in the west, you know, not going to other cultures, you know, you had like William Blake, the poet who would greet people sitting nude in a tree pretending to be Adam. And you know, even a lot of our great scientists just had so many, we call them quirks. But I'm forgetting which one, one of the great atomic scientists. Everything in his life had to be A multiple of three. He would even walk around buildings three times before going in. Just, you know. And I think that whole. There's a. Socially. There's a social discourse of, wow, you know, brilliant people. They're different. No, they're not. People are simply different. And lots of people who, you know, go to work and are doing actuarial tables for insurance companies, for example, are going home and maybe sitting naked in trees and pretending to be Adam as well. It's just that we've learned to hide all this. We feel so much shame, and we consider normality. It's, like I said, a tiny little bandwidth. I think right now, even if you look historically at old diaries from the 16 or 1500s, people accepted behavior in others that we just don't. You know, there'd be somebody who always wore very odd clothes, and they'd just be like, yeah, that's Fred. That's what he does. You know. So I think that. That, you know, understanding the full range of human behavior is really important because then people. It gives you so much license to understand yourself. And there's something so beautiful about that. Why do I hear birds talk? Well, they have a very special place in my life. What's that place?
- [43:56]
A
Right.
- [43:56]
B
Don't drug it out of. Don't drug it out of them.
- [44:00]
A
And the thing is that that is the way we. That that is the way people are. I mean, some people hear music. I mean, yes, they just create symphonies and they, you know, I mean, and some people are artists. They just see something. They see a vision and they paint it. But as long as it doesn't make us uncomfortable, that's. It's good.
- [44:20]
B
Right? But if you talk about almost any of these things, because I. I often do this thing where I'll just ask people to tell me, like, what are the components of your thinking? Not, like, who do you vote for, but how do you put a thought together? And it's wildly different. Like, somebody I know actually has an inner government that debates everything and then votes.
- [44:39]
A
That's internal family systems.
- [44:42]
B
Yeah. But it's. This is really intense. Like, there are elections. It's just. Oh, there's a whole structure.
- [44:48]
A
Yeah.
- [44:49]
B
Oh, yeah. No, it's very elaborate. It's this whole infrastructure, and that's how he thinks. And I know somebody whose thoughts always go up and down on an elevator. So, like, the elevator has to go to a certain floor if it's a family thought inside. And this is something that the neuroscientist Danielle Seth and I have talked about inside. We're all radically different. But, you know, almost all these people, including my government person, have said, you know, I once mentioned this to a therapist and they said oct. You know, I mean, you know, Elizabeth, you know, so I love your idea. I think we do need a DSM for the rich diversity, the breathtaking diversity of the normal.
- [45:37]
A
Because it is so interesting, too, because as a teenager, I had an eating disorder. And I definitely, if you take out the dsm, I fit all the ice. The criteria for ocd, and I have zero signs of that in my life now. In fact, I wish I could be more compulsive and, you know, and rigid with myself. I'm. I feel like. So there's that component of it, too. How we are at any given moment is just how we are in this moment.
- [46:08]
B
Absolutely.
- [46:09]
A
A week from now, a year from now. So this idea of putting a label on somebody's mental health and saying they have this condition and they're going to need this medication and.
- [46:20]
B
Right. And it's lifelong. It's their brain it's happening in. Yes, because I had. I mean, I had eating disorder behavior as a teenager as well. And it's react. It's often just very reactive as. As is most of what we experience. And I find it's interesting that we're also, I think, a bit brainwashed, to coin a phrase, by this whole brain chemistry neurotransmitter. You know, it's your hippocampus kind of thinking that, you know, if I said the happiest moments in your life, just random because suddenly, like, it just happens to you or an event, people always an event. Had my child, got this job, got accepted into med school, whatever. But then you say, but then why would you believe your unhappiness is coming from nowhere except brain chemistry. It doesn't even. It's not even internally consistent.
- [47:17]
A
Right.
- [47:17]
B
It makes no sense.
- [47:19]
A
That's right.
- [47:20]
B
And again, I think for women, for black folks, it has been very weaponized. One of the things I cover in the book was this period when in the 60s and 70s, doctors were actually contemplating doing brain surgery on black protesters on the grounds that that was a brain dysfunction and not racial oppression. I mean, it's. It's horrendous. And one very brave man actually stopped that. A civil rights attorney named Kamowitz put a stop to that. But yes, it's. It's, you know, it's awful when you start saying it's just something happening in the brain. You get to do anything you want to the brain.
- [48:04]
A
Right, Right. And for Me reading your book helped me realize the lasting effects and the way in which the whole impact of eugenics still is at play here. Because that was this idea of, like, trying to get everybody, corral everybody into one look, one type of behavior, one way of thinking, and then. And then that's where I go back to. Like, again, anything else was just uncomfortable. You know, they were afraid of anybody who wouldn't. Because if somebody's going to think differently or willing to act differently, you. You can't control them.
- [48:47]
B
Absolutely. And it's very embedded in our culture. And I think the US hasn't come to terms with the fact that we. We were into eugenics before Germany, we stayed into eugenics, and we're still there. Even things like that are seem sort of trivial like that Ladies Home Journal. Can this Marriage Be Saved column that ran for decades, I mean, I think from 1953 to the early aughts, was founded by a eugenicist. I mean, he practiced. Paul Popeno. He practiced marriage counseling because he wanted white couples who were upper class, of course, to stay together and breed more.
- [49:24]
A
Oh, interesting.
- [49:26]
B
So, I mean, we're. Yeah. And that column was, you know, the women were always the ones who had to, you know, take the accountability. If, even if the men cheated or abusive, they were still supposed to be the ones to fix it. So we're still very. We're very embedded in that. And I mean, we're seeing that with this administration. We're seeing that frequently.
- [49:47]
A
Yeah. I used to read that column as, like. Like as a kid.
- [49:52]
B
I did, too.
- [49:54]
A
So now I'm thinking that was my problem. It wasn't my brain chemistry. It was reading that column because, oh,
- [50:00]
B
my gosh, I think that's the piece
- [50:03]
A
that I do feel like all the research around the power and the benefits of meditation and mindfulness, that's going to change things because your beliefs change your neurochemistry, so more than I think medications can. So we have to figure out, you know, how. How we're going to make use of that important piece of information, you know? You know, because going back to what you said again, too, if you want to go back to this, like, biological basis of. Of mental health problems, well, what about all these other influences? You know that.
- [50:44]
B
Absolutely right. And we know that even. And I'm sure you're very familiar with this research, that writing down three things you're grateful for every day actually, over time makes you far, far happier, or at least, you know, if. Even if you don't write it down, articulating it Somehow, so. Absolutely. And I think that we are. We're learning so much about that aspect of the mind. It's almost like that part of our thinking is, you know, is. Is in graduate school at this point, but the people that actually deal with the mind don't study it. I mean, they. Some of them do. Some of them, you know, work with life experience and want to do a more holistic practice. I have friends in psychiatry who are doing that, but they are having to buck the trend and buck the, you know, the. The reimbursement problem and all of those things. So it's. And neuroscience as well, is, you know, we're learning again. We're kind of in grad school over there, and I feel like we're still in the. In grammar school if you do a very typical psychiatric visit. And I want to say that most of psych drugs are dispensed by general practitioners, which is a huge, huge problem in itself.
- [52:01]
A
Yeah, yeah.
- [52:03]
B
It can actually be.
- [52:04]
A
It can. Just having a number of clients. I'm. I'm not. I don't have my private practice anymore, but clients, though, that the. A primary care. Taking it over from some. A psychiatrist can be really helpful for facilitating the process of getting it or whatever. In some cases. In some cases, yeah. I want to tell you something, though, that I'm thinking about talking to you because I interviewed her last month, but it's a woman named Sally Mislansky, who's now actually a therapist herself, too, but she had therapy with Dr. Dan Siegel, who is a, you know, psychiatrist. But he brings a different philosophy, and he brings a more mindful approach in his treatment with her. She was. When he was first working with her, and this was 30 years ago, he had to diagnose her with, at the time, multiple personality disorder, which is now dissociative identity disorder. In any case, his treatment with her was sitting with her and being with all of the different states, which, you know, you would call the personalities that would show up that were a result of her trauma. And you'd be probably really interested in reading it because it was exactly that approach. Just sitting. Sitting with her, witnessing it, allowing her to integrate things that were so painful during her childhood that she had to put up memory barriers just to protect yourself. And it's fascinating because it's. It is very much along that lines of what, like, Dorothea Buck would have said, like. Yes, and this goes back to what I. What I feel like I've learned is that it's uncomfortable. It's uncomfortable to be with somebody who's all of a sudden, you know, grown woman who maybe all of a sudden is expressing very childlike concerns or worries or experiences it. How do we find a way to get more comfortable with a broader range of emotions? We're all so uncomfortable with. With our emotions, you know, so. So anyway, you might want to check that book out, and I'm mentioning it too, for listeners because it's very much aligned with what we're talking about today.
- [54:12]
B
Absolutely, I will check that out. And that, you know, being with people, that was the heart of Soteria and the heart of the moral treatment and the heart of what Buck did. And maybe part of the answer is getting more of that neuroscience awe at the wonder of the mind and what it can do and sort of trying to, as a group, detach things from good, bad, shame, normal, abnormal. I think once you stop thinking that way, because, you know, one of the things Buck said in her book, and I talk about it in my book as well, is that what she felt like, psychiatry as it was being practiced. So she was in there at the kind of early biological psychiatry era and got, you know, meds, she got shock treatment, she got insulin shock, which we don't do anymore because it was brutal. She said that this is brutalizing the clinicians too. You know, Pinel was just like, he loved his patients so much. He was sort of giddy about it. You can see it in his writings. And so is Mosher, and so is Buck. And I interviewed the man who worked with Buck and developed trilog with her, a psychotherapist named Thomas Bach. I was very lucky to be able to interview him. You know, obviously she's. She died in 2019 at the age of 103. And he was giddy about it. The people, the clinicians who participated in trialogue were just. They loved it. They loved it. I mean, they could see it themselves making a huge difference in real time in some cases, just by sitting and listening. Push past the discomfort. That's pretty amazing. Like, we all want our presence on this earth to show that kind of value in, you know, in. Right in front of us. And. And they were getting that.
- [56:04]
A
Yeah, yeah.
- [56:06]
B
I think most of us want that anyway.
- [56:09]
A
I think, too. I mean, it's at our core, we are relational beings. I mean, we want to be in relationships with other people, and we need relationships with other people. I mean, that's how we keep our newborns alive, by just being with them, holding them.
- [56:25]
B
Absolutely. And, you know, most of us share our lives with at least an animal or Two at some point.
- [56:32]
A
Right.
- [56:32]
B
They have that same hunger.
- [56:34]
A
They do, they do. And they. Yeah. And they want that same connection. They show the same enthusiasm for your present. Like when you're there, they respond.
- [56:44]
B
Right. And that feeling that, oh, just my being here can make this dog ecstatic or make the cat. Yes. It's a very fundamental need. I mean, I think if you don't have that need and I, you know, you do see people who don't, then something's been warped and they're development.
- [56:59]
A
They've been shaped by some experience. It's probably not their neurochemistry.
- [57:05]
B
No, not their neurochemistry. It's probably a life experience.
- [57:09]
A
Right, right, right. Gosh, this has been great talking with you today. Before I let you go, though, I just want to check in and see is there anything you're currently working on. Are you planning on doing any more writing or do you have what's hard?
- [57:23]
B
Yes, always doing writing. And I did want to plug my Psychology Today column. I'm the mad woman out attic. And so I'm getting engaging with all these things in real time, things that are developing, things that we could be doing better. And they now have a system, they just started two weeks ago where you can sign up to get email notifications, so.
- [57:45]
A
Oh, good.
- [57:45]
B
I'd love for people to check it out. Sign up. I only post every few months, so it's not going to be over.
- [57:52]
A
Really good, though. I mean, you, you're. Because you're really getting into the things that people are talking about. And it's a good column.
- [58:00]
B
Thank you. Thank you. So I love that. And yes, I've started doing some work on. This is just a completely. It's not a different subject matter, but a different approach. I've been doing some writing on Shakespeare and his mad characters because I just. I don't think anyone has ever written madness as well. He gets so much. Right. And so I'm looking at that and trying to approach it so you don't have to be a Shakespeare nerd or even fan, but just looking at, like, what happens in plays like Lear with the sane characters and the mad characters, because the mad characters are always the only ones who know what's going on.
- [58:37]
A
Right, right. And we can often relate to multiple characters in different ways. Right. That's that again, going back to that internal family system. There's all these parts of ourselves. Absolutely. This one static thing. We are this fluid, constantly changing entity, you know?
- [58:56]
B
Yeah, yeah. So that's. That's something I've been working on. And. Yeah, and I've been working on. I did a piece for Slate on Jeffrey Epstein and his. He was such. So into eugenics. He was so there's kind of like a new wave of billionaire eugenics, and I've been writing about that.
- [59:16]
A
Or the exposure of an old wave.
- [59:19]
B
Exactly.
- [59:20]
A
That's a new wave of seeing it. Yes.
- [59:23]
B
But now we have. Chris. Yeah. We have something that can actually gene edit. So we're. We're in danger of actually making some pretty big mistakes.
- [59:31]
A
Yeah. Yeah. All right. I'm gonna check that one out. I really do. I can highly recommend your Psychology Today, and I will check that out as well.
- [59:38]
B
Thank you.
- [59:39]
A
Well, thank you for your time today. It's been a real pleasure.
- [59:42]
B
Yeah, it was delightful. Thank you for having me. Thank you for listening to this episode of the New Books Network. We are an academic podcast network with the mission of public education. If you liked this episode, please share it with a friend and rate us on your preferred podcast platform. You can browse all of our episodes on our website, newbooksnetwork.com Connect with us on Instagram and BlueSky with the handle ew booksnetwork, and subscribe to our weekly substrate newsletter at newbooksnetwork.substack.com to get episode recommendations straight to your inbox.