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National Empowerment Center
Book Reviews

A Fight to Be: A Psychologist's Experience From Both Sides Of The Locked Door
By Ronald Bassman

A Book Review by Paul Pines, 9/2009

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A Fight to Be Ronald Bassman's book, A Fight To Be, is a daring and insightful portrait of psychosis and the "mental health" system we have put in place to address "chronic and persistent disorders." The book is a weave of three distinct threads: it is a personal memoir, a clinical meditation and, finally, rising from that dialogue, a call to action. The first thread offers the authority of the author's direct experience as one who was diagnosed with and treated for paranoid schizophrenia; the second gives us the perspective of an informed, acutely observant clinician; the third, an opportunity to exercise our social conscience--or, perhaps, in the spirit of Dietrich Bonheoffer, to create one.

The memoir is a classic Hero's Journey in which the hero undergoes a series of challenges involving descent into the underworld, pitiless adversaries and death and resurrection in order to realize an authentic self and heal the Wasteland, a culture without compassion. As Parzival, the 12th Century Grail knight learns, "We are what we make of our pain." It is the lesson of one transformed through struggle from warrior to healer, but where Parzival's journey begins in Edenic innocence, Bassman's starts at the extreme of psychological fragmentation.

In 1966, at the age of 23, following the completion of a Masters program in clinical psychology, Bassman makes a conscious decision to let go of an image of himself attached to his academic achievement which he can no longer support. What he has taken for granted as his inevitable identity has the heavy hollowness of a suit of armor. He describes taking it off in a way that allows the reader to experience the consequences of doing so without agenda, and herein lies the power of his tale.

Bassman's response to stripping away this weight is an altered consciousness, a "lightness of being" that includes paranormal powers. Playing four-card monte at a gambling table in Union City, New Jersey, he anticipates the cards well enough to walk out a winner, an event the author looks back on and wonders "if the many phenomena... I remembered did in fact happen." Shortly thereafter, at the urging of his parents, he winds up in the psychiatric ward at Fair Oaks Hospital, in New Jersey, where, as he tells us, "I entered the abyss." He is there stripped of his dignity, and given the message that he is doomed to a life of mind-numbing drugs, and is subjected to a regimen of the now discredited and potentially life-threatening insulin coma therapy. Bassman receives forty-nine insulin treatments and is released seven months later. Six months after that, through an act of will, he has weaned himself off all medications. His success at remaining medication and symptom free ever since, while performing as an academic, clinician and author, has shaped his position as an activist/advocate for a drug free approach to the treatment of psychosis and other mental health issues.

In a seamless way, the author draws on his clinical as well as his personal experience of psychoses to discuss what he has learned. For this he references on the pioneering work of Jung and R.D. Laing, who assert that there is logic to delusional content which can be decoded. While Laing, and to some extent Jung, are viewed less favorably now than they were in the 60s and 70s, the basic humanity of their "depth" approach to the inherently healing impulse of the psyche, in connection to the humanity of the healer, have been displaced by a culture of measurement, and a distancing professionalism. This has been fortified by the advent of designer drugs which offer hope with one hand and take it away with the other by enabling the management of psychotic symptoms to serve as an end in itself. To accept this, Bassman asserts, is to abandon the hope of integration, a journey which challenges us to heal the Wasteland and renew our capacity to relate with compassion, to validate the fight to be. He renews the call for a psychotherapy that, in Laing's words, "must remain an obstinate attempt of two people to recover the wholeness of being human through the relationship between them."

A strong advocate of self-help and consumer empowerment, Bassman takes on a number of controversial issues. Should we force medication on those who refuse it? Can we commit an individual to an institution against his will who has done nothing but raise the suspicion that he may be a danger to himself or another? Should we put the mentally ill in penal institutions? How do we help those who have fallen into the abyss? As an activist, Bassman's voice deserves to be heard. Even where there is no definitive answer, the point of view is that of knight-turned-healer. He suggests that the measure of a civilized society is its ability to locate the potential for wholeness in those who suffer most. Bassman asks: “But what of the person who is called mad? Is there no psychotherapy that will work with her? I believe such work is possible, but therapists must firmly relinquish their reliance on diagnosis and their illusions of precise predictability. Each person lives a personal and special life story.”

A Fight To Be, is a crie du Coeur, as well as a penetrating psycho/social analysis of where we find ourselves in relation to those who are among the most disenfranchised. It is also the last task of the Hero, who must not only return from the depths, but to tell the story of his journey so that we may be renewed. The challenge to retain hope on the way to self empowerment is daunting. Though people diagnosed as mentally ill are no longer chained to the walls of institutions, there are still the invisible shackles of stigma and poverty reinforced by a system that accepts hopelessness as the status quo. Bassman, the clinician, describes a typical Day Treatment group: “The glazed eyes, the missing teeth, the trembling hands, distended stomachs, slurred speech and other drug-related side effects will not be remarkable there. I look and see squelched dreams and resignation. I wonder what their lives were like and what could have been?”

The Wasteland this book describes is a system/culture that has become so compartmentalized that it can no longer address those it serves. Psychiatrists dispense drugs. Social workers and psychologists treat individuals in sessions of limited frequency and duration with therapies that lack continuity and depth. Even under the best of circumstances, treatments are directed at symptoms rather than underlying causes. What we are talking about is a degree of unconsciousness in the system as profound as in those who seek refuge in it. "Staying out of the hospital is essential to the development of self-confidence," writes Bassman. "It is almost impossible not to measure your success by the increased time you are able to take care of yourself."

Here, says the author, is the evidence. He argues that this condition can be changed. His authority is earned. Bassman speaks as one who has suffered the fierce storms of psychosis and overcome the message that life holds no more for the consumer than the narrow protocols of drugs and containment. His is the voice of one who has defied therapeutic stagnation and by an act of will moved beyond the received wisdom of "normalcy" to find the authentic voice that informs these pages with the promise of hope.

I believe that as long as a person is alive, some seed of hope, some possibility is there waiting to be fertilized. Hope fights the fear, nurtures the courage and inspires the vision and the work required to resist giving up... Deep in the recesses of our being there are safe sanctuaries, secure hiding places for never fully lost dreams. But sometimes they are hidden so well that we can no longer reach those parts of ourselves.

*Paul Pines is the author of the novel The Tin Angel (Wm. Morrow) and a memoir My Brother's Madness (Curbstone Press). He has published six books of poetry, selections from which have been set by composer Daniel Asia, and recently finished an opera libretto based on The Tin Angel. Pines is a psychotherapist in private practice in Glens Falls, NY. Click to purchase: Fight To Be