Episode 16
Soteria House Part 1
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HOPE on the Other Side Episode 16 Program Notes:
Soteria House is a residential treatment and rehabilitation project for young adults with early onset psychosis, and possible schizophrenia. It lasted from about 1971 until 1983 in Palo Alto, CA. It was originated by a pioneering, visionary, psychiatrist named Loren Mosher, M.D. He was a psychiatrist who had an esteemed and varied career; he was founder & chief of the National Institute of Mental Health’s Center for Studies of Schizophrenia from 1968 to 1980.
The recommendation from Dr Ken Campos in this episode of HOPE is that caregivers, mom, dad, who have a loved one with a diagnosis of schizophrenia, Board and Care staff, and to others—go back to your doctor, your psychiatrist or primary care doctor to see if there are any other medical tests to rule-out any commonly treatable, or rare and unusual conditions causing psychosis. What is left is “psychosis for which we have no known cause.” Then, coupled with at least 6 months minimum of active symptoms and a functional decline, we enter the world of schizophrenia.
Please get my free report on psychosis when you enter your e-mail on my website & sign up to receive my monthly e-Newsletter. What you will see it that in modern medical psychiatry that “Schizophrenia” is diagnosed by the absence of other illnesses or conditions, which may cause psychosis, and a functional decline, and at least a 6 month period of active symptoms.
What we call “schizophrenia” or chronic psychosis, it is likely several different brain conditions, according to former NIMH Director, Dr Insel, it may actually be a variety of illnesses or brain conditions: a neurochemical problem, genetic issues, metabolic issues could be present, and brain anatomical issues. The condition may even include something possibly health-promoting (such as fever to fight off infection) or even perhaps, rarely, a growth step in human consciousness. In the near future it is the SCP Foundation plan to establish several Schizophrenia Care Project Foundation residential treatment and support homes where a diagnostic re-evaluation will be possible.
Dr Loren Mosher came to the conclusion that the moral treatments of the 1800’s had some value, and that perhaps using lower doses of the dopamine blocking anti-psychotic medication or even in some cases, none at all AND coupling this with various psychosocial support methods in a compassionate setting he could treat schizophrenia.
Soteria House is that program and it was successful for a sub-set of folks showing up with a crisis of psychotic experiences. What Dr Mosher was able to do was to set up a residential treatment house for about 6 people at a time. This psycho-social behavioral program was centered on personal relationships, and the staff “being with” the folks. The staff avoided labeling, stigmatizing or contradicting the folks experiencing their crisis of psychosis. They insured safety however as they “validated” the unusual experiences of the folks living at Soteria house. House staff were non-professional, occasionally there would be a psychology intern, and they generally spent 24 to 48 hour shifts to help relationship building. The staff had particular personality characteristics and values: they were psychologically strong and resilient people, they were open to different states of consciousness and lacked dogmatic views about mental illness or about schizophrenia; they were fairly independent minded people; they were warm and empathic. So, a compassionate, caring personality was very important to the success of this project. The staff were thought to be intuitive, flexible, and tolerant of out-of-the-ordinary speech, thought and behaviors compared to the typical American psychiatric mental health hospital staff
Dr Thomas Insel looked at the long-term treatment of schizophrenia and came to a surprising result. He concluded that long-term care, using persistent and chronic use of dopamine blocking, anti-psychotic medications for schizophrenia is not that effective after all. A research study form the Netherlands was cited.
In the early 1970’s, the World Health Organization (WHO) looked at the results of schizophrenia-care in both Developing countries, such as Guatemala and Developed countries, such as the USA. In a 2 year study with over 1000 patients the folks in developing countries with fewer folds on chronic medications actually did better with regard to functional recovery than those in the developed countries on chronic routine doses of medications. Possible reasons for this dramatic difference are as follows: family support, (that included parents, board and care operators, hospital staff, and those working closely with those people living with schizophrenia); support and tolerance in the community at large; increased paying job opportunities; extended networks of friends and distant relatives, & supporters.
Dr Nancy Andreason’s findings that one of the older antipsychotic medications causes brain tissue / grey matter cell loss with chronic use of many years. This argues that, indeed, the treating psychiatrist and the person living with schizophrenia and the caregivers should be careful in the use of long-term medications.
More Soteria History: In a published study group from 1976 to 1981, the was a significant improvement in functional ability and an equal reduction in the symptoms of psychosis when treated with this intensive human contact. Steven Morgan, who was the program developer of a Soteria house in the state of Vermont in the early 2000’s has a great description of “BEING WITH” in his YouTube lectures. From both Loren Mosher’s experience as well at the Vermont experience “being with” is defined as an a “Active Process” of attending to and following-up with client’s path or journey; to openly listen to the person’s story and thoughts with genuine curiosity; to be willing to take risks with that person who is having a psychotic episode. Interpersonal relationships was a key part of the Soteria treatment. This was successful for a significant subset of folks with psychosis, but there was another sub-set of clients which did require moderate to higher doses of anti-psychotic medications, some required ongoing routine use of the medications.
The “narrative restructuring;” the meaning aspect of psychotic experiences is a very significant thing. And this will be more fully addressed in another podcast.
Other projects like Soteria House Palo Alto opened in Bern, Switzerland, also in Sweden in the 1980’s. Since then, other homes have opened in Hungary, Finland, Germany, and in the UK, among other places. Autonomy and dignity are the goals.
Dr Ken Campos is promoting the Schizophrenia Care Project (SCP) and the SCP Foundation whose wish and vision is to create and promote a clearing for the balanced, healthful, meaningful and respectful lives for those folks living with schizophrenia, chronic psychosis, and for their loved ones.
Finally, to make the recommendation again: if funding and insurance is available, then proceed with a diagnostic review, and if there is no other medically treatable cause for psychosis, then proceed with a human, interpersonal intensive, family oriented, and community supportive schizophrenia care program such as described here.
Links
- San Diego Weekly Reader, Vol 23, No. 2, January 09, 2003
http://www.moshersoteria.com/articles/after-all-these-years/
- Bio of Dr Loren Mosher
http://www.moshersoteria.com/bio-of-loren-mosher-soteria/
- State of Vermont – Soteria Presentation
Steven Morgan, project developer of the Soteria Vermont
- Long-Term Treatment post by Dr Thomas Insel
- Dr Ken Campos Face Book Community Page & Group
Schizophrenia Care Project
and open public group:
S-Project
