Friday, February 5, 2010

Tom Wootton - Visionary off the Edge

In three previous blog posts I created the impression that my friend Tom Wootton’s new book, Bipolar in Order, is a prime example why American civilization is in decline, which is true. I also made it clear that Tom is a visionary who got us thinking that we could lead better lives than the poor unfortunate souls operating within the “normal” emotional bandwidth.

In his 2007 book, The Depression Advantage, Tom represents himself as a person with “over 40 years of direct personal experience with bipolar symptoms” who, during one 15-year stretch “fluctuated between increasingly more extreme mania and depressions.”

But in January 2009, I played a video of a presentation he gave, in which Tom disclosed that, as well as manias and depressions, he had also experienced schizophrenia.

Schizophrenia? I got my first taste of trouble during this time when I asked Tom to write a guest blog for me. He suggested the preface to the new book he was working on. Fine, I said, so long as the preface works as a blog piece. Often they don’t. His draft repeated his assertion that he had experienced schizophrenia. I said he needed to delete the schizophrenia reference and replace it with psychosis.

Here is the email in full he sent back to me: “What is the difference between schizophrenia and psychosis?”

Suffice to say, our guest blog project never got off the ground.

Tom, in his new book, retreats from his claim of having experienced schizophrenia, instead referring to his delusions and hallucinations as “bipolar I schizoaffective.” Even the experts are confused about the schizoaffective diagnosis, but it’s safe to say that there is an overlap between bipolar and schizophrenia and that many individuals experience symptoms of both.

Nevertheless, in his book, Tom claims expertise in helping others gain control over the psychosis in schizophrenia, but he cites no case studies. His one and only example is John Nash in the movie version of “A Beautiful Mind.” John Nash is a real individual, but the movie treatment, especially in relation to his psychotic delusions, is fictional.

“In the beginning of the movie,” Tom writes, “his hallucinations helped him to see solutions to his mathematical problems. This ability earned him a Nobel Prize.” Imagine, Tom asks, if John Nash had been able to harness those abilities.

Sylvia Nasar’s book of the same name, upon which the movie is based, paints an entirely different picture, revealing an early John Nash as high functioning, though clearly a social oddball. The mathematical breakthroughs that led to his Nobel Prize occurred BEFORE his schizophrenia broke out. Once the delusions set in, by Nash’s own admission, he lost 25 years of his life to the illness.

Ms Nasar’s narrative suggests that Dr Nash may have been straddling a dangerous fault line where genius borders madness, but that is an entirely different discussion.

Since Tom gives workshops, it is reasonable to assume that he would have been anxious to document people he worked with, people he rescued from the hells of schizophrenia who went on to lead full lives. I would have loved to have read about this. Instead, all we get is a fictional example.

A fictional example.

This sort of thing goes over well in public speaking, where a skilled presenter can manipulate crowd emotions. At the NAMI CA conference last year, Tom actually drew applause from his fictional use of John Nash. But the left-brain world of the printed word demands substantial non-fiction documentation.

A personal example then? At both the conference and in his book, Tom describes experiencing the sensation of being crushed by a bus and finding himself inside his wife. Tom tells us this delusion is part of a pattern of similar ones that visit him. But instead of being freaked out, Tom tells us, or trying to put these delusions out of his mind, he incorporates these experiences as part of his own personal growth.

Had Tom restricted himself to his own experiences and built on them, he would have found many people who would have related. I, for one, have a creative and very quirky mind. Weird shit runs through it. And, like Tom, I too find myself contemplating my weird shit rather than ignoring it.

To be crushed by a bus. To be dead and in someone else’s body. Had this experience happened to me, automatically I’d be asking myself stuff like: What was it like to be dead? Is dead overrated? When is going into dead mode helpful to me?

Trust me, Stephen King turned this kind of thinking into a career. Tom is using it to seek greater insight and spiritual growth. Tom’s point is that it is not the psychosis that is bad - it’s how you react to the psychosis. Oddly enough, this is vintage Freud. The pre-brain science era DSM I of 1952 views mental illness as maladaptive reactions to one’s environment, including “schizophrenic reaction.”

There is some validity to rehabilitating this viewpoint, and the time is ripe for a full and spirited conversation. To a certain point, we all have the power to choose. But the kind of fleeting psychosis Tom experiences - or for that matter my own weird shit - is not schizophrenia, nor, for that matter, heavy duty psychosis. Being robbed of all power to reason is a whole different phenomenon.

There is a dangerous tendency to romanticize and trivialize schizophrenia, then morally judge those who fail to live up to our own often unrealistic expectations. Tom’s book is rife with this. Clearly, he has yet to spend a day negotiating rounds of transactions in public places dragging around someone with raving psychosis. Until he does, Tom needs to stick to his own experiences.

Reality is a treacherous place, where ivory tower ideas tend to founder. Tom compares himself to Columbus finding a new world. After reading Bipolar in Order, I see him more as a blind visionary who sailed off the edge.

This series of blog pieces sets the scene for future conversations. Stay tuned ...


Anonymous said...

well put and please if you have time comment on the "experts' in his latest book -

David K said...

Excellent synopsis and critique. The evidence is an imperative. Anecdote, even collections of anecdotes are not sufficient, though enough of them could posit a tentative, testable hypothesis, perhaps. I'm sorry that you're friendship is being tested in this way. And, I'm proud of you for having the courage to maintain your empirical position, John. Nice work here.

John McManamy said...

Many thanks, David. It wasn't easy being so harsh on someone who has done so much to help me. But the facts do not sustain the position Tom has staked out. Imagine if Eli Lilly were to use a fictional movie example as its only proof for a new drug. We would laugh. And I would, too, were it not for the grave risk this type of misinformation poses for those with serious mental illness, as well as their families.

Don't get me wrong. I love a good speculative discussion. One reason I attend psych conferences is that the speakers often throw out ideas they are typically never allowed to publish. I'm also willing to give "air time" to findings that don't pass empirical muster.

But always this is in the nature of asking questions rather than pretending we have the answers. We need to be asking questions. But, like you, I'm wary of those who think they have the answers.

Tony said...

Psychosis as a learning experience? Definitely something out of the days of Freud. I heard such malarky on Furious Seasons. Maybe therapy could lessen the impact of psychosis, but it could also validate those thoughts leading to more problems: more psychosis or resistance to medical treatments ("but the therapist said these thoughts are a 'part' of me"). I've had frequent long bouts of psychosis; I didn't find any aspect of them edifying. More like a feeling Leatherface is pursuing you with a chainsaw.

I can understand Tom's confusion. When reading the DSM, I wondered if maybe I had schizophrenia. A little more research will show there is a marked degree of difference between bipolar disorder and schizophrenia. I am not happy I have the former, but I am fortunate that I don't have the latter.

John McManamy said...

Hey, Anonymous. I'm in no position to offer specific comments on the credentials of the experts that Tom has gathered around himself. I am sure they are very well-qualified. But I can offer this general observation:

Whatever the qualifications these experts may have, their primary purpose is to endorse Tom and make him appear credible. I suspect that they get off on being associated with a prominent recovery spokesperson and guru, which means they may be blinding themselves to Tom's obvious faults.

No doubt, one or two of these experts has tried to reel in Tom before he self-destructs (as I tried to do), but that does not appear to be working.

At best, one or more of these experts convinced Tom to stop representing himself as someone who experienced schizophrenia, and it appears that someone coached him in Schizophrenia 101. But to read or hear Tom expound on schizophrenia is as painful as encountering Sarah Palin talking about foreign policy. Tom just doesn't know the subject.

Tom has a brilliant mind and has had great success in computer technology. He can read a manual and master in one day what would take even experts months to figure out. But serious mental illness is a whole new ball game. The brain and personality is far more complex than either a computer or a world-wide network of computers. Tom has yet to familiarize himself with the network, and until he does neither his own genius nor his team of experts will serve him.

Thanks for asking ...

John McManamy said...

Hi, Tony. Funny you should mention Furious Seasons. Tom was featured in an interview there. He is also becoming a poster boy for the antipsychiatry movement. More recently, Tom is blogging for John Grohol's PsychCentral. Grohol is an antipsychiatry sympathizer and a huge fan of those who advocate that we can simply think away all our problems, regardless of their nature.

Here's the irony. Tom sees himself at the center of his own universe (he's Christopher Columbus, remember?) and one with revolutionary new ideas, but in reality he has allowed himself to become just another voice in antipsychiatry pedaling old Freudian dogma.

The tragedy is Tom has brilliant insights and could have done so much for us.

Tony said...

I have gathered that PsychCentral does not take bipolar disorder seriously, even suggesting it is not an illness. After seeing that, I just can't take that site very seriously.

About "Depression Advantage": I see advantages from a scientist's (my line of work) perspective which states an advantage leads to passing on your genes to the next generation. Wootton argues that the advantage is spiritual. But in Western society, for 2000 years, the spiritual were cloistered away as priests and monks and nuns. No chance to pass on the genes. If depression and spirituality are linked, then the depression genes would not have been passed down because monks and priests (usually) don't have children. These genes would have been lost and depression would have disappeared. But that is not the case, obviously. Not every trait has an advantage. Some just happen due to the variation in our genes. That variation happens to ensure organisms can adapt to changes. But that variation can lead to illnesses like bipolar disorder and schizophrenia.

John McManamy said...

Hey, Tony. Bingo with PsychCentral. I've expressed my views on Grohol in previous comments, so I won't belabor the point. Suffice to say, his major area of expertise is as a web entrepreneur.

Very interesting observations on the spiritual advantages Tom is propounding. Even not cloistered away, those of spiritual disposition tend to be socially marginalized, with similar lack of success in passing on their genes.

A lot of us wish we were more spiritually adept than we are, but I guarantee that no one wants to be any more socially marginalized than our illness already makes us. It's one thing for Tom - who spent three years as a monk - to want to find enlightenment. But most of us have far more modest goals - such as a steady income, friends, a relationship ...

Yes, I too occasionally write about spirituality, as I believe we all do have a spiritual need. And I do believe depression has made me a better writer and filled me with insights I wouldn't have had had I been born more upbeat. But I'm monkish enough as it is without turning it into a full-time pursuit.

Re gene variations, there can be adaptive advantages, but as one Darwin psych expert said, we have stone age brains housed in 20th century skulls - or something like that. Anxiety is a good trait to have when a tiger is stalking you by the water hole. Too much anxiety in this age means you are too fearful to even say hi to people.

The Darwin psych people also make a case for the adaptive advantage to depression, but only to a point. No one has made a convincing case for psychosis. The best one can do is make a case for a kind of quasi-psychosis, what I call weird shit running through the brain, the kind of stuff that fuels a creative mind. Psychosis is more like when there is a failure in the weird shit setting. I'm okay with my weird shit. The kind of psychosis that resulted in John Nash losing 25 years of his life? You gotta be kidding.